Adult Transition Services Ltd

Updated 13 April 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 completed by 3 inspectors. One inspector completed the site visit and 2 inspectors made calls to people and their relatives.

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 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 7 March 2023 and ended on 15 March 2023. We visited the location’s office on 7 March 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 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 with 3 people and 8 relatives of people who used the service about their experience of the care provided. We spoke with 5 members of staff including the registered manager and care workers.

We reviewed a range of records. This included 2 people’s care records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 13 April 2023

Adult Transition Services Limited is a domiciliary care agency. They provide personal care to people living in their own homes. 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 the inspection 5 people were receiving personal care.

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.

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

Right Support:

People were supported with medicine administration. Risks to people had been assessed and mitigating strategies had been implemented. Staff understood safeguarding procedures and how to protect people from potential abuse and harm.

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.

Staff ensured they asked consent from people before supporting them. Staff understood people’s rights to refuse care. Staff supported people with dignity and respect.

People were involved in their care planning. Staff asked if people had a preferred gender of staff and assessments of people's needs, including those in relation to protected characteristics under the Equality Act were reflected in people's care plans.

Right Care:

Staff recruitment and staff training required improvement. We found the provider had not always followed safer recruitment procedures to review staff's past work history. Staff had not always had sufficient training to provide person centred, safe care to people.

Records were not always kept up to date. Daily notes were not always completed, and some information was missing or incorrect in people’s care plans. Therefore, there was not always evidence if staff supported people with their assessed needs.

People told us staff were kind and caring. We received positive feedback on how staff related to people.

People were supported to remain healthy and access healthcare professionals if needed. Staff supported people with meal preparation as required.

Right Culture:

Management oversight required improvement. Audits had not been completed to review and analyse information to ensure records were kept up to date and to identify where the service needed to improve.

People, relatives and staff had not consistently been asked to feedback on the service and there were no actions plans implemented to drive improvements.

People and relatives did not always have the information required to contact the service or understand the service’s procedures. However, people, relatives and staff spoke positively about the registered manager and provider.

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

Rating at last inspection

This service was registered with us on 12 January 2022, and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service and in part due to concerns received about staffing and the quality of care provided. A decision was made for us to inspect and examine those risks.

Enforcement and Recommendations

We have identified breaches in relation to staff recruitment, staff training and management oversight 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.