Utmostcare Limited

Updated 12 November 2022

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 carried out by one inspector and two Experts 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 and specialist housing.

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.

Notice of inspection

We gave the service 48 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.

What we did before the inspection

We reviewed information we had received about the service since it was registered with the Care Quality Commission on 15 February 2021. We sought feedback from the local authority.

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We used all this information to plan our inspection.

During the inspection

During the inspection we spoke with 10 people using the service and 8 family members. One additional family member shared feedback via CQC’s online feedback form.

We also spoke with 9 members of staff, including three senior care workers, three care workers, one agency care worker, the operations manager and the registered manager, who was also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also received email feedback from one additional care worker.

We reviewed a range of records. This included 6 people's care and support plans, as well as people's medicines records where they received support with this task. We looked at three staff files in relation to recruitment, training and supervision. We reviewed a variety of records relating to management of the service including policies and procedures, accident and incident records, compliments and complaints and audits of the service.

After the inspection

We continued to review records shared electronically and continued to seek clarification from the provider to validate evidence found. We sought feedback from professionals and received a response from three professionals during the inspection process.

Updated 12 November 2022

About the service

Utmostcare Limited is a service providing care and support to people in their own home. The service offered both regular daily visits to people receiving personal care and live-in staff members providing a 24-hour support service. At the time of the inspection the service was supporting 33 people. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

People were protected from the risk of abuse and people told us they felt safe. We found other risks to people using the service were not clearly identified and managed. We also identified concerns in relation to the safe management of medicines. Staff had access to sufficient supplies of personal protective equipment (PPE) and received training in infection control, however risk assessments lacked sufficient detail in relation to managing risks of infection and the use of cleaning products.

Systems were in place for staff recruitment, induction and training, with ongoing support and monitoring via supervisions, spot checks and staff meetings. We have made a recommendation in relation to obtaining staff employment histories. We have also made a recommendation in relation to continuity of staff deployment, to ensure people receive care from staff who understand their needs and have sufficient travel time to consistently meet preferred visit times.

People's needs were assessed prior to the delivery of care. We have made a recommendation in relation to person-centred care planning. People told us they received care from staff who were kind, caring and treated them with dignity. Staff spoke about people with respect and understood the importance of protecting people’s privacy and seeking consent.

Staff told us they were supported by the management of the service. The service and provider had processes in place to monitor the quality and safety of the service. We found however these systems had not been fully effective in identifying the concerns we found. Systems were in place to respond to concerns or complaints, and people told us the management of the service was easily accessible.

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 but we have made a recommendation in relation to how people’s mental capacity is described within care records.

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 15 February 2021 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

The service was responsive to our feedback and told us about actions they were taking to mitigate risks, including additional staff training and increased auditing of the service.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.