Peak Care Homecare

Updated 28 September 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

This inspection was carried out by two inspectors 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. It provides personal care to people living in their own homes. This service also provides care and support to people living on-site in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care.

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 not a registered manager in post. There were two deputy managers who formed the management team.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 02 August 2022 and ended on 22 August 2022. We visited the location’s office on 03 August 2022.

What we did before the inspection

We reviewed information we had received about the service since the last 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 used all this information to plan our inspection.

During the inspection

We spoke with two deputy managers, the nominated individual and four members of staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We also spoke with two people and nine relatives. We reviewed five people’s care plans and risk assessments, three staff recruitment files and a range of other written records.

Updated 28 September 2022

About the service

Peak Care Homecare is a homecare and extra-care service which provides personal care. The service provides support to older people, this also included a person with a learning disability. 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 21 people using the service and 17 of these people were supported with personal care.

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

The provider did not always follow their own policies and procedures. Staff did not always receive up to date training to ensure safe and effective care for people. Staff did not always receive formal supervisions of their performance and development. Following concerns being raised by inspectors, the provider took action to ensure training took place where needed and supervisions were booked for staff.

People did not have ‘as needed’ medicine protocols in place and people’s medicine administration was not always recorded in line with best practice guidance. Following this being raised by inspectors, the provider ensured systems were put in place for staff to record medicine administration safely and ‘as needed’ protocols were put in place.

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; however, systems in the service did not always support this practice.

People and relatives told us they felt safe using the service. Risks to people were assessed safely and people were protected from avoidable harm. Staffing levels and recruitment were safe. There was evidence of learning lessons when things went wrong.

People’s needs were assessed effectively. Staff worked with other agencies to support people. People were supported to maintain their nutrition and hydration.

People and relatives felt the service was person-centred and staff were supported by the management team. The management team was approachable for people, relatives and staff and feedback about the service was sought regularly.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there was one person using the service who had a learning disability.

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 10 April 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service. The inspection was prompted in part due to concerns received about management and provider oversight at the service. A decision was made for us to inspect to include the key questions of safe and well-led to examine those risks.

Following concerns found during the inspection with systems and processes around the Mental Capacity Act, a decision was made to also open the inspection to the domain of effective.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of the full report.

You can see what action we have asked the provider to take at the end of this full report. The provider sent evidence to us of some effective actions they took to mitigate these risks.

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.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Peak Care Homecare on our website at www.cqc.org.uk.

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 a breach in relation to management and leadership at this inspection. 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.