Crest Care Solutions Ltd

Updated 2 August 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

This inspection was carried out by one inspector.

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 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, who is also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. The provider had two directors, including the registered manager. The other director was the care manager, with responsibility for the management of services in the Reading area.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because the service is small, 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 12 June 2023 and ended on 24 July 2023.

What we did before the inspection

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 reviewed notifications and information we had received about the service since the last inspection. We sought feedback from the local authority quality assurance and safeguarding team, and other professionals who work with the service. We checked information held by Companies House and the Information Commissioner’s Office. We checked for any online reviews and we looked at the content of the provider’s website. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.

During the inspection

We visited the site office on 30 June 2023, reviewed various material in connection with the management of the service. People using the service were not able to communicate verbally with us. We spoke with five relatives and 1 friend to help us understand their experience about the quality of care people received. We spoke with 8 staff, including the registered manager, the care manger and 6 staff. We reviewed a range of documents, including people’s care records and daily notes. We looked at 5 staff files in relation to recruitment, staff training and supervision. These included the most recently appointed staff within the service and those subject to the government’s sponsorship scheme. We examined a variety of records relating to the management of the service, including the provider’s policies, procedures, accidents and incidents and quality assurance audits.

After the site visit, we continued to seek clarification from the registered manager to validate evidence found and received additional documents and information to inform our inspection. We received feedback from 8 health and social care professionals who engaged with the service.

Updated 2 August 2023

Crest Care Solutions Ltd is a domiciliary care agency and supported living service, which provides personal care to people living in their own homes in the Reading and High Wycombe area. This includes 24-hour care and support to people living in 'supported living' settings, so they can live in their own home as independently as possible. At the time of inspection, the service was supporting 5 autistic people, with associated complex needs. The service is also registered to support children between the ages of 4 and 18, younger people, older people, autistic people and people living with learning disabilities, mental health needs, dementia and other associated needs.

In supported living services people's care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for supported living; this inspection looked at people's personal care and support.

Not everyone using Crest Care Solutions Limited receives a regulated activity. The service supports other people who do not receive personal care. CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

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.

Staff understood and effectively delivered care and support in accordance with the principles and values of Registering the Right Support and other best practice guidance. This ensured that people who used the service lived as full a life as possible and achieved successful outcomes.

Right Support:

People experienced good quality care with good outcomes. There were enough staff with the right mix of skills and experience to meet autistic people's care and support needs.

Staff had completed required training to support autistic people, those living with learning disabilities, mental health needs and other associated complex needs, including epilepsy.

Staff had been recruited safely, which meant the provider could be assured they were suitable to work with people made vulnerable by their age, autism, learning disability or mental health needs.

Staff had training in safeguarding and knew how to report any concerns. People's risks were clearly assessed, and clear guidance given to staff to minimise and manage risks safely. People were supported to manage and take their medicines safely and on time.

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 least restrictive practice.

Right Culture:

The ethos, values, attitudes and behaviours of the registered manager and care manager ensured people led confident, inclusive and empowered lives. The provider promoted a positive culture within the service that was person-centred and achieved good outcomes for people.

People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs.

Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity. People, relatives and staff told us they felt valued and listened to by the registered manager and staff. The registered manager assessed and monitored the quality of the service and effectively operated systems and processes to ensure compliance with the regulations. This meant the provider assured that required learning and improvements had been identified and implemented.

Right Care:

People experienced personalised care which promoted their dignity, privacy and human rights. People and relatives were supported to express their views and be involved in making decisions about their care.

The registered manager and care manager made sure that staffing was organised so that people received care and support from familiar staff. People and relatives told us they experienced good continuity and consistency of staff, who understood how they wished their privacy and dignity to be maintained. This resulted in people feeling they were respected and valued.

Staff had the required skills and time to recognise when and how to give people compassionate support when they needed it. Staff supported people to make choices for themselves and promoted their independence.

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 6 May 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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.