Solitaire Homecare Services Limited

Updated 8 June 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 an inspector, an assistant 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. 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 we needed to be sure that the provider or registered manager would be in the office to support the inspection and to give people time to consent to speaking with us.

Inspection activity started on 10 January 2023 and ended on 3 February 2023. We visited the location’s office on 11 January 2023 and 12 January 2023. We carried out phone calls on 10, 11 and 19 January 2023 and continued to request and review evidence from the provider throughout this period.

What we did before the inspection

We used information gathered as part of monitoring activity that took place on 23 November 2022 to help plan the inspection and inform our judgements. We also 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 with 6 people using the service and 7 relatives of people using the service. We spoke with 5 staff members and the management team: the registered manager, the deputy care manager, 2 care managers, a director and a compliance manager. The registered manager was also the nominated individual for the service. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We looked at 2 staff recruitment records and 7 people’s care records.

After the inspection visit, we used remote technology such as video calls to enable us to engage more with managers of the service, and electronic file sharing to enable us to review documentation as part of this performance review and assessment. We also spoke with a professional involved in the care of some people using the service.

Updated 8 June 2023

About the service

Solitaire Homecare Services Limited is a domiciliary care agency providing the regulated activity of personal care to people. The service provides support to older adults with a range of needs including people living with dementia, people with mental health needs and physical disabilities. At the time of our inspection there were 80 people using the service.

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.

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

People often did not receive their calls at the agreed times and calls could take place hours later than planned. People’s risks and medicines were not always effectively managed. People were not protected by clear safeguarding policy and process and the service did not always identify safeguarding concerns and shortfalls in the service. People told us they felt safe and raised no concerns around staff practice.

People’s needs were not always fully assessed, and staff were not always provided with the training and guidance about their individual needs. People were supported to eat and drink by staff and to access healthcare support. 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; although the policies and systems in the service did not always support this practice as far as possible.

People and relatives described positive relationships with staff and told us they were caring and friendly. People told us they were involved in decisions and choices about their care, and felt well supported. We found however the service was not consistently caring based on the impact of late calls and where concerns had been raised about some people’s care, these were not addressed to drive out poor care experiences.

People’s feedback showed that they did not feel the need to complain, but if they did, concerns were addressed quickly. Managers could not demonstrate the learning and analysis taken from complaints, and how this had been used to improve the service.

We identified a breach in relation to good governance at the service. This was because the systems and processes built around meeting people’s needs were not effective, including around training oversight, risk management and learning from information of concern. People and relatives spoke positively about the service overall and managers recognised improvements were required and attributed this to staffing issues at the service and within the sector.

Rating at last inspection

The last rating for this service was Good (published in September 2018).

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, Effective, Caring, Response and Well-Led key questions sections of this full report. The provider has taken some action to mitigate risks, and further improvements will need to be made and embedded in practice. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified 5 breaches in relation to safe care and treatment, good governance, staffing, complaints and safeguarding processes at this inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.