We carried out a review of the data available to us about Supreme Homecare Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Supreme Homecare Limited, you can give feedback on this service.
Supreme Homecare Limited is a domiciliary care agency which provides assistance with personal care to people living in their own homes. At the time of this inspection 120 people were receiving support with personal care needs. 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 received a service which was exceptionally caring. People and their relatives spoke very highly of the staff team and told us staff went above and beyond their role when supporting them. People told us they were treated with the upmost respect by staff who were kind and compassionate. They told us they were empowered to be in control of their lives and that staff respected their wishes and supported them to live their lives as they wanted. Staff took time to get to know the people they supported, and they ensured people’s protected characteristics were understood and respected. Staff at all levels spoke about people with genuine fondness and demonstrated their commitment to providing people with the highest standard of care possible.
People felt safe with the staff who supported them. People were supported by adequate numbers of staff who were safe to work with them. The provider’s systems protected people from the risk of abuse. People were protected from the risks associated with the control and spread of infection. There were systems in place for the safe management and administration of people’s prescribed medicines. People received their medicines when they needed them from staff who were trained and competent.
People were supported by staff who were trained and competent in their role. People were assessed before they used the service to ensure their needs and preferences could be met. Staff understood the importance of ensuring people's rights were respected and protected. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People's health care and nutritional needs were monitored and understood by staff. People received personalised care which met their needs and preferences. People were involved in planning and reviewing the care and support they received. People's communication needs were assessed and understood by staff. People knew how to raise any concerns they may have and were confident that action would be taken to investigate and respond to their concerns. People could be confident their wishes during their final days and following death were understood and would be respected by staff.
The service was well-led by a provider and registered manager who demonstrated a commitment to monitoring and improving the service people received. They worked collaboratively with other professionals to improve people’s lives. Professionals were overwhelmingly positive about the management, staff team and of the support people received. People’s views were valued and responded to as were the views of the staff team. People were supported by staff who felt very well-supported and valued. The provider and registered manager were aware of their legal responsibilities and promoted an open and honest approach which had been adopted by the staff team.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 27 September 2019).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Supreme Homecare Limited on our website at www.cqc.org.uk.
Supreme Homecare Limited is a domiciliary care agency that provides personal care and support to people living in their own homes. The agency also provides short notice and short term care support along with a structured programme for reenabling people who have had recent health problems. 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. When we inspected the service there were 74 people receiving the regulated activity.
People’s experience of using this service and what we found
The frequency and duration of visits varied depending on people's individual needs. However, we received mixed feedback about people’s experiences of whether the care workers arrived on time and whether people had regular care workers.
The provider had safeguarding systems to protect people from the risk of abuse or unsafe care. Staff were aware of the procedures, had received training on it and knew what action to take. One person told us, “They’ve [the service provider] been coming for years and the carers make me feel safe.”
Staff assessed and reviewed people's physical, mental health and social needs. Care plans had been developed with the close involvement of the person and where appropriate their families and representatives.
Medicines were managed safely, and people received their medicines as prescribed. One person told us, “They [care workers] make sure I’ve taken them [medicines], they keep an eye on it for me.”
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.
People told us staff treated them with kindness, compassion and respect and made sure their dignity was maintained. One person told us, “They [care workers] always close the curtains and doors for my privacy.”
Staff had received training that was applicable to their role and training was on going. Staff had been supported to extend their roles as champions in areas of their own interests. Staff were supported by the area managers, registered manager and provider through regular staff meetings, supervision and appraisals. Staff were supplied with personal protective equipment for use to prevent the spread of infections.
People received support to maintain good nutrition and hydration in line with their personal choice and preferences. The service worked well with other agencies and professionals to support people's health and well-being.
There were systems in place to monitor the quality and safety of the service. People were regularly asked for their views about the service they received.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 12 January 2017)
Why we inspected
This was a planned inspection based on the previous rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Supreme Homecare Limited on our website at www.cqc.org.uk.
Staff we spoke with knew how to keep people safe and what to do if they had concerns about a person’s safety. Staff told us they had received training to protect people from abuse and were able to share examples of different types of abuse to demonstrate their understanding. Staff were confident to recognise and report concerns about people’s safety. They were confident that the registered manager would then take appropriate action.
Staff promoted health and safety and safe working practices. Staff told us that they were confident to recognise hazards in people’s homes. They developed plans to reduce risks and remove hazards if possible. For example, one staff member told us, “We look for hazards such as rugs and other obstacles that prevent us using equipment or place the person at risk of falling.” Staff told us that they had received training to help them to identify hazards in people’s home environment. When risks could not be removed they were managed safely.
One person had behaviour that challenged staff. Staff told us that they had received training that enabled them to offer safe support. One staff member said, “We have been taught to manage the behaviour safely. We redirect them if necessary. We speak with them and offer reassurance. This works.”
People were supported by staff who had sufficient time to carry out tasks required of them safely. People told us that staff had time to meet their needs. Staff said that they would never leave a person until they had done everything they needed. They said that if that meant they were late to their next call they would contact the office to inform them of this. Staff working at the office had lists of people who wanted to be informed if calls were going to be late. Staff also had a list of ‘high risk’ people who could not miss calls or had to have calls at set times. Staff had the resources to ensure that these calls were covered.
People we spoke with told us they had not experienced a missed call. The provider’s audits identified that there had been a decreasing number of missed calls over the last six months. Processes to manage this had been reviewed and undated. For example staff were given new rotas when changes were made as previous arrangements were not considered to be as effective.
People were supported by staff who had been recruited safely. Staff told us they were subject to pre-employment checks which included references from previous employers and checks with the Disclosure and Barring Service (DBS). The DBS helps employers make safer recruitment decisions and prevent unsuitable people from working with people.
People’s medicines were given to them in a safe way. People required varying levels of support to take their medicines. Some people told us they managed their own medicines. One person told us, “The managers assessed me and I can self-medicate. Carers still help me out to put cream and ointment on due to my lack of mobility when sitting.” Another person told us, “My husband does my medicines, although staff apply my eye drops.” Staff were able to offer flexible support depending on people’s needs. Staff encouraged people to be as independent as possible. One staff member told us, “We follow medication assessments. One person can manage if we just pour out the liquid medicine. We encourage people to be independent.” When staff supported people they completed records to show that the person had taken their medicines.
Staff told us that they had received training before they administered medicines and this gave them confidence to do it safely. One staff member told us, “The training was really good.”
We saw that staff had been observed to ensure they were competent to administer medicines. Senior staff told us how they did this on a regular basis. Other arrangements were in place to ensure medicines were given correctly. One staff member told us, “Staff have to count medicines on site and call in if there is a discrepancy. This offers a safeguard.” Senior staff told us that medication errors were monitored as part of quality auditing and there had been no errors since the time of the last inspection. This suggested that monitoring processes were robust and working to protect people from errors.
The inspection was announced and took place across three days from 11 January 2016. The provider had short notice that an inspection would take place. This was because the organisation provides a domiciliary care and we needed to ensure that the registered manager would be available to assist with the inspection. At the time of this inspection 154 people were receiving a service from the provider. At the last inspection in December 2013, we found the provider was meeting all of the requirements of the regulations we reviewed.
There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Feedback we received from people who used the service and their representatives was mixed. Some people considered that staff sickness and changes of staff over the last few months had impacted on the delivery of care and support they or their relatives received from the agency. Some people indicated that their calls were not always at the preferred time or with their regular carers, but most people acknowledged they were informed prior to any change. The management team acknowledged there had been an acute period of staff sickness. As a separate issue, staff recruitment and retention was also acknowledged as being historically challenging, but recruitment had now improved.
People told us they felt safe when being supported by their carers. Staff had received training in safeguarding and were aware of their responsibilities to report safeguarding concerns or poor practice. They were confident any safeguarding concerns raised were acted on. Risks to people were identified, assessed and reviewed to ensure their on-going safety. Staff recruitment processes were in place to ensure only staff suitable to support people living in their own homes were employed.
Most people we spoke with considered their carers had the skills and knowledge to meet their individual needs. 88% of people we surveyed considered their carers had the skills and knowledge to give them care and support they needed. Six people considered their or their relatives’ carers required more training or supervision. Staff were able to share examples of how they offered people choices, gained their consent, respected people’s rights and how they involved them in decisions about their care. Staff ensured people had sufficient amounts to eat and drink and supported people with accessing healthcare services where required.
Most people considered they were always supported by staff that were kind and compassionate. Staff were able to share good examples of how they treated people with dignity and respect and promoted their independence. People were involved in their assessments and planning and reviewing their care with other key people in their lives. People knew how to complain about their service although some people felt the agency did not respond well to complaints they raised. Some people felt new staff did not consistently understand their care needs and preferences.
Most people considered the agency was managed well. Some people and staff felt that communication could be improved. We saw there were systems in place to gain people’s views and to monitor the service. The management team completed regular quality checks. These included checks on staff working with people in the community in addition to a range of audits carried out. Managers reported they had recently been through a challenging period with acute staff sickness and that they had recently made some changes to management arrangements. These were part of the provider’s ongoing efforts to improve people’s experiences.
People told us they were regularly asked if their service was satisfactory. They told us that the senior staff assessed their needs. In the care plans we looked at we saw the instructions for staff that minimised risks to people's health and well-being.
Staff told us they had training in safeguarding people from abuse.
Staff also told us they felt supported to work effectively.
The provider had systems in place that enabled them to identify problems swiftly and act upon them to keep people safe at all times. This meant that the service was managed well.
People said that they were treated with respect and their privacy was maintained. They said that the staff were always polite and helpful.
We asked what they thought of their care and they replied with comments like 'They're brilliant' and 'Absolutely brilliant'.
People told us that they felt able to raise any issues with the manager or staff should they have any concerns. Staff talked of their awareness of how to keep people safe from harm. Staff told us about the training that the service had arranged for them so that they would recognise abuse and how to report it.
People told us that staff were punctual and reliable. People's relatives told us that staff were always friendly and professional when they visited. One person said 'They are very good. Very punctual' and another said 'Can't grumble about the staff'.
People we spoke with said their comments were listened to. A relative said that they would not hesitate to talk to staff if something was wrong.