Care Delivered Ltd

Updated 10 November 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 two inspectors.

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.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the registered manager would be in the office to support the inspection. The inspection started on 15 September 2022 when we visited the office and ended on 5 October when we provided feedback.

What we did before the inspection

We looked at information we held about the service. This included details about incidents the provider must notify us about, such as allegations of abuse and serious accidents and incidents.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used information gathered as part of our monitoring activity that took place on 22 August 2022 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.

During the inspection

We reviewed two people's care plans and care records. We looked at five staff files in relation to recruitment and supervision. We also looked at policies and procedures and records related to the management of the service.

During the office visit we spoke with the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. After the visit to the office we made calls to two care staff and two representatives of people receiving care to get their feedback on the service.

Updated 10 November 2022

About the service

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 did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

Care Delivered Ltd is a domiciliary care agency which provides personal care and support to people living in their own homes. 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 the inspection the service was supporting two people with personal care support.

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

Right Support: There were sufficient numbers of suitably skilled staff to meet people's assessed needs. Staff knew people well and understood their communication needs. Staff were recruited with specific communication skills to meet people’s individual communication needs.

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. Some staff we spoke with could not demonstrate a good knowledge of how the Mental Capacity Act 2005 (MCA) applied to their role.

We have made a recommendation about reviewing staff MCA training to ensure staff have a good understanding of their responsibilities

Right Care: The process of assessing and managing risk was not consistent and risk assessments did not always include adequate risk management plans. We found risks around eating and drinking and skin integrity were not adequately assessed. Medicines support in care plans was not in line with current best practice guidelines.

We have made a recommendation about delivering medicines support in line with current best practice guidelines.

People’s representatives told us they thought people were safe and well looked after. Staff understood how to recognise and report any signs of abuse or neglect.

Right Culture: There was a system for monitoring the quality and safety of the service, but this was not always effective and had not identified some of the issues we found. The provider was not following safe recruitment procedures as they had not obtained a full employment history when recruiting new staff. People told us managers regularly checked on them to make sure they were happy with their service. Staff were positive about the support they received from the management team and the provider.

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

This service was registered with us on 10 October 2020 and this is the first inspection.

Why we inspected

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

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 are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to risk management and recruitment at this inspection. We have made recommendations about reviewing MCA training and consulting best practice guidance for supporting people to manage their medicines. 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.