Background to this inspection
Updated
13 July 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection was undertaken by 3 inspectors and an expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in Cornwall. This service also provides care and support to 2 people living in 1 ‘supported living’ setting in Greenwich, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post. They were also the provider.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 8 June 2023 and 12 June 2023. We visited the location’s office and people’s homes on 8 June 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the Cornwall and Greenwich local authorities. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We visited 3 people and spoke to them and their relatives. We spoke to 5 staff members including the registered manager. We spoke to 1 person, 3 relatives and 4 staff members by phone.
Updated
13 July 2023
About the service
Senior Healthcare is a domiciliary care agency providing personal care in a supported living setting in London, as well as in private houses and flats in Cornwall. The service provides support to older people some of whom may be living with dementia as well as younger people and people who have a physical disability, learning disability or autism. At the time of our inspection there were 8 people using the service.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Governance processes had not always been used effectively to identify improvements.
Risk assessments were in place but did not always contain information about how to reduce risks to people.
Recruitment and induction processes were in place, however there were gaps in some new staff’s employment histories. This meant the registered manager could not be fully assured the staff were suitable to work with vulnerable adults.
There was no evidence available regarding the training of staff who worked at the supported living service. Assessments of the competency of staff who administered medicines had not been completed.
The service was working within the principles of the Mental Capacity Act 2005 (MCA).
People were involved in planning their own care and making decisions about how their needs were met. People's care plans described their needs and preferences and how staff should meet these.
People received kind and compassionate care from staff who protected and respected their privacy and dignity and understood and responded to their individual needs.
Staff gave positive feedback about the registered manager. Staff received training in safeguarding and people received information about how to raise concerns.
People and staff were provided with opportunities to share their views of the service.
Right Support:
The model of care and setting supported people’s choice, control and independence. People were supported to be independent and had control over their own lives. People made choices and took part in meaningful activities which were part of their planned care and support. People were supported to take part in activities and interests in their local area.
People’s care and support was provided in a safe, clean, well equipped, well-furnished and well-maintained environment.
Reasonable adjustments were made for people so they could participate fully in discussions about their support wherever they needed to.
Staff supported people with their medicines in a way that promoted their independence and achieved good health outcomes.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Right Care:
Staff actively promoted equality and diversity in their support to people. They understood people’s cultural needs and were able to provide culturally appropriate care.
People were able to communicate with staff and understand information given to them by staff who supported them consistently and understood their individual communication needs. People who had individual ways of communicating, were supported to use these in their interactions with staff.
People’s care plans reflected their range of needs and this promoted their wellbeing and enjoyment of life. People enjoyed undertaking activities and pursued interests that were tailored to them. They were given the opportunity by staff to actively engage and try new activities.
Right Culture:
People received good quality care and support from trained staff who were able to meet their needs and wishes. People and those important to them, were actively involved in planning their care.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 22 February 2021 and this is the first inspection.
Why we inspected
We undertook this inspection to provide a rating for this previously unrated service.
Enforcement
We have identified breaches in relation to the governance of the service.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.