Focus Care Link

Updated 13 October 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 and 2 Expert by Experience who contacted people who used the service and relations after the visit to the agency’s office. 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.

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 we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 16 August 2023 and ended on 22 August 2023. We visited the location’s office on 16 and 17 August 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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

We spoke after the inspection with 13 people who used the service and 4 relatives to get their view of the care supported by FCL. We spoke with 7 staff this included the registered manager, the branch manager, 1 care coordinator, 1 field care supervisor and 3 care workers.

We looked at 10 care records, which included risk assessments and medicines records were required and 5 staff recruitment records. We looked at a range of other records required to the running and management of the agency.

Updated 13 October 2023

About the service

First Care Link (FCL) is a domiciliary care service providing personal care to older people, people with dementia and people with physical disabilities. 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. At the time of our inspection there were 108 people using the service.

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

Due to an issue with the service digital care planning system, risks in relation to people receiving treatment and care were not always managed appropriately. Quality assurance systems were in place, but these were not effective as they did not identify some of the shortfalls identified during our inspection. We found shortfalls in the implementation of the new digital care planning system. The registered manager told us that the information has not transferred from the old to the new system. This meant there was a risk that care was not always managed appropriately. The registered manager acted on our feedback from the inspection and was in the process of addressing the issues identified.

People told us they felt safe receiving the service and policies and systems were in place to help protect people from the risk of harm, abuse, and improper treatment. Medicines were administered following best practice. Staff told us they felt supported, and we saw that they had been safely recruited, appropriately inducted, trained, and that their competency to perform their role, was assessed. People told us they had confidence in the staff's abilities and that they treated them with compassion.

People's nutritional and hydration needs were met. 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 who used the service, relatives and care workers told us that office staff were supportive and addressed any issues most of the time.

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 good (published 2 May 2018)

Why we inspected

We received concerns in relation to missed and late calls and the management of pressure ulcers. As a result, we undertook a focused inspection to review the key questions of safe, effective, and well-led only.

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 good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe 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.

Enforcement and Recommendations

We have identified breaches in relation to guidance in how to respond to minimise risks assessed in relation to people receiving care and governance systems within the service.

We have made recommendations for the provider to seek guidance from a reputable source on staff deployment and how calls are scheduled or planned to meet people's needs and on administering time sensitive medicines and the impact this might have on people.

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.