Caring@Home Ltd

Updated 31 December 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 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, which 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 no registered manager in post. The service was being managed by the owner. The owner was also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

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 would be in the office to support the inspection.

Inspection activity started on 1 December 2022. We visited the location’s office on 1 December 2022.

What we did before the inspection

The provider was asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. Prior to our inspection, we reviewed information we held about the service. This included any information received and statutory notifications. A notification is information about important events which the provider is required to send us by law. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with 5 people, 7 relatives, the care manager, the office manager and the owner of Sylvian Care Swindon. We reviewed a range of records relating to people's care and the way the service was managed. These included care records for 4 people, staff training records, 4 staff recruitment files, medicine records, quality assurance audits, complaints records, and records relating to the management of the service.

After the inspection

Following our visit to the office we continued to gather evidence and we contacted 8 care staff. In addition, we contacted the commissioner of services for their views.

Updated 31 December 2022

About the service

Sylvian Care Swindon is a domiciliary care agency providing care to people in their own homes in Swindon and the surrounding area. At the time of our inspection 29 people were receiving the regulated activity of personal care from the service. Not everyone using the service received personal care. CQC only inspects where people receive personal care, which 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 not always protected from abuse and harm. Risk assessments were not in place to identify how potential risks should be managed to reduce the likelihood of people experiencing harm. However, staff understood the risks to people and delivered safe care in accordance with people's support plans. There were sufficient staff available to be deployed to keep people safe and meet their needs. However, people told us staff were not punctual and nearly everyone we spoke with had experienced a missed visit. The service aimed to ensure only suitable staff were selected to work with vulnerable people, and checks were carried out to allow safe recruitment decisions to be made. However, some staff had been deployed to work with people before all the background checks had been fully completed. We found people had not been harmed.

People's care plans were person-centred and focused on what was important to people. However, nearly everyone we spoke with told us they had not seen their care plan and they had not been asked for their views. This meant people were not fully involved in their care.

Systems to monitor, maintain and improve the quality of the service were not broad ranging and were mostly, ineffective. None of our concerns were identified by monitoring systems employed by the owner.

Some people and their relatives did not speak positively about the management and said they had no confidence in them.

Staff knew how to report any concerns relating to people’s safety and the service had systems to report and investigate concerns. Each staff member had received an induction and training to enable them to meet people's needs effectively. We saw that supervision meetings were planned, and spot checks were conducted for staff who told us they felt supported by the owner to perform their role. Staff spoke positively of the management and were given appropriate responsibility.

People were supported to have maximum choice and control of their lives and staff provided them with care in the least restrictive way possible and acted in their best interests; the policies and systems in the service promoted this practice.

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.

At the time of the inspection, the location supported one autistic person. Staff demonstrated a good knowledge of how to safely and effectively support this person. We assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

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

This service was registered with us on 13 October 2021, and this is their first inspection.

Why we inspected

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

We have identified a breaches in relation to Regulation 12 (safe care and treatment) and Regulation 17 (good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

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

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.