Continuity Healthcare Services Private Limited

Updated 19 January 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 carried out by 2 inspectors who visited the service and 2 Experts by Experience who made telephone calls to people who used the service. 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 homes.

Registered manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave a short period of notice of the inspection to ensure the registered manager and provider were available. Inspection activity started on 7 December 2022 and ended on 15 December 2022. We visited the office location on 7 and 13 December 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection and sought feedback from the local authority and commissioners who work with the service. We reviewed the information submitted to us by the provider in the Provider Information Return (PIR). This is information providers are required to send us annually with key information about the service, what it does well and improvements they plan to make.

During the inspection.

We looked at 12 people’s care records, 4 staff recruitment records and a variety of information relating to the management of the service.

The Experts by Experience contacted 22 people and relatives by telephone to gather feedback of their experiences of the service.

The inspectors spoke with 17 staff including the provider, the registered manager, the service delivery manager, the manager of the Hinkley satellite office, call schedulers, the human resources manager, the risk and safety officer, and a number of senior care staff.

Updated 19 January 2023

About the service

Continuity Healthcare Services Private Limited is a domiciliary care agency providing personal care to adults in their own homes. This includes people with dementia, learning disabilities or autistic spectrum disorder, mental health needs, sensory impairments and physical disabilities. 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. At the time of inspection 183 people used the service.

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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and autistic people. We were not assured people were supported to make decisions about their care and welfare in their best interests.

Since our previous inspection, processes, procedures and checks on the quality of service people received had been improved. However, governance systems were not established and did not always identify areas where improvements were required. New governance systems and quality assurance procedures needed to be embedded into practice, to ensure their effectiveness.

Staff training had improved, and staff received training in areas such as how to recognise the signs of abuse, and how to administer medicines safely. The provider had plans to continue to improve training.

Overall, people and staff confirmed there were enough staff to attend scheduled care calls. However, people told us sometimes staff arrived late, and communication when care staff were running late could be improved.

People’s medicines were administered by trained staff. There was paperwork in place to record when people received their medicines. However, processes needed to be improved to record when people should receive medicines on an ‘as required’ basis, and how patch medicines should be administered.

It was not clear if people were supported to have maximum choice and control of their lives and if staff supported them in the least restrictive way possible and in their best interests. Policies and procedures were in place to test people’s capacity, however, there was a lack of understanding about when best interests’ decisions were required for people’s care, and how decisions should be recorded.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published July 2022) and there were breaches of regulations. This service has been in Special Measures since July 2022. During this inspection the provider demonstrated that improvements had been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection. At this inspection we found the provider remained in breach of regulation 17 good governance.

Why we inspected

We carried out an announced comprehensive inspection of this service in May 2022. Some breaches of legal requirements were found. The provider was in breach of regulation 12 safe care and treatment, regulation 13 safeguarding, regulation 19 fit and proper persons, and regulation 17 good governance. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe, effective and well led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Continuity Healthcare on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to regulation 17 good 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.