Archived: Superior Healthcare

Updated 24 February 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place between 6 and 14 December 2017 and was announced. We gave the service notice of the inspection site visit because we needed to be sure that people who wanted to speak to us were available during the inspection.

Inspection site visit activity started on 6 and ended on 7 December 2017. It included talking to and meeting people using the service and their carers, interviewing staff, pathway tracking and reviews of records. We visited the office location on 6 and 7 December 2017 to see the registered manager and office staff; and to review care records and policies and procedures.

We looked at five people’s care and support records, associated risk assessments and medicine records. We looked at management records including five staff recruitment, training and support records and staff meeting minutes. We observed people spending time with staff. We spoke with the provider, the registered manager, five staff, and fourteen people who use the service and their relatives.

The inspection team consisted of three 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. We used information the provider had sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also looked at notifications received by the Care Quality Commission. A notification is information about important events, which the provider is required to tell us about by law.

Before the inspection we sent surveys to people, their relatives and community professionals who had involvement with the service and staff. We sent questionnaires to nine people and received feedback from three of them. We also received feedback from 28 staff and four community professionals. We sent questionnaires to nine people’s relatives but did not receive any responses

Updated 24 February 2018

This inspection was carried out between 6 and 14 December 2017 and was announced. Notice of the inspection was given because we needed to be sure that people who wanted to speak to us were available during the inspection.

This service is a domiciliary care and nursing agency. It provides personal care and treatment to people living in their own houses and flats in the community. It provides a service to children, younger disabled adults and older adults. Many people using the service had significant and ongoing healthcare needs. There were 52 people receiving a service from Superior Healthcare at the time of our inspection.

The registered manager had been working at the service since July 2017 and was registered with the Care Quality Commission CQC) shortly before our inspection. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the last inspection on 3 October 2016, we asked the provider to take action to make improvements to the way they assessed and mitigated risks, managed medicines and ensured that information within care plans reflected people's assessed needs and preferences.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions, safe and responsive to at least good. The provider had completed all the actions and the key questions, safe and responsive are now rated good.

The way people’s medicines were managed had improved since our last inspection. Guidance was available to staff and people received their medicines as their healthcare professional had prescribed. Medication administration records contained updated guidance to staff and were fully completed. Changes in people’s health were identified quickly and staff supported people and their relatives to contact their health care professionals. People were supported to eat and drink enough and prepared meals to their preferences. Staff followed safe practices to prevent infections.

People received care tailored to them. Assessments of people’s needs and any risks had improved since our last inspection. Guidance was now available to staff about how to keep people safe and provide each person’s care in the way they preferred. Staff supported people to take part in leisure activities they liked and played with children to support their development.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The registered manager knew when assessments of people’s capacity to make decisions were needed. Staff assumed people had capacity and respected the decisions they made. When people needed help to make a particular decision staff helped them. Decisions were made in people’s best interests with people who knew them well, including their relatives. The registered manager understood their responsibilities under Deprivation of Liberty Safeguards (DoLS), and had checked to make sure no one was deprived of their liberty.

People told us staff were kind and caring and treated them with dignity and respect at all times. People were given privacy. Staff were kind and caring to people and supported them if they became anxious. Everyone was supported to be as independent as they wanted to be. People who wished to, were supported to develop their independence. People received care in the way they preferred at the end of their life from staff and health professionals.

Staff knew the signs of abuse and were confident to raise any concerns they had with the registered manager and provider. People and their representatives told us they were confident to raise any concerns they had with staff and that any concerns they had raised had been acted on. Complaints received were investigated and responded to. Action was taken to prevent to concerns occurring again and people received an apology.

Staff were deployed in teams to provide people’s care and treatment. Staff deployment was based on the needs of the person and the skills and competence of staff. Staff rotas were planned in advance and any gaps of leave were covered. Staff were recruited safely and Disclosure and Barring Service (DBS) criminal records checks had been completed. Staff were supported to meet people’s needs and had completed the training they needed to fulfil their role. Checks were completed to make sure training had been effective and staff were competent. Staff were clear about their roles and responsibilities and worked as a team to meet people’s needs.

The provider and registered manager had oversight of the service and checked the service people received met the standards they required. People, their relatives and staff were asked for their feedback and any concerns were acted on and used to improve the service. Accidents and incidents had been analysed and action had been taken to stop them happening again.

Staff felt supported by the registered manager, they were motivated about their roles. They shared the provider’s visions of a good quality service and were encouraged to be transparent in their communication with people and their relatives. An experienced member of staff was always available to provide the support and guidance staff needed, including outside of office hours. Records in respect of each person were accurate and complete and stored securely.

Services that provide health and social care to people are required to inform the CQC, of important events that happen in the service like a serious injury or deprivation of liberty safeguards authorisation. This is so we can check that appropriate action had been taken. We had been notified of all significant events at the service.

Services are required to prominently display their CQC performance rating. The provider had displayed the rating in their public office and on their website.