Archived: Key Care & Support Limited

Updated 18 July 2019

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 Care Act 2014.

Inspection team

The inspection was undertaken by one adult social care inspector.

Service and service type

This service is a domiciliary care agency. It provides personal or nursing care to people living in their own homes.

The provider of this service was also registered as manager with the Care Quality Commission. This means they are legally responsible for how the service is run and for the quality and safety of the care provided. A branch manager was appointed to manage the day to day operation of the service, although was not registered with the CQC.

Notice of inspection

We gave the service 3 days’ notice of the inspection. This was because it is a small service and we needed to be sure someone would be in the office to support the inspection. The inspection started on 25 May 2019 and ended on 31 May 2019. We visited the office location on 29 May 2019.

What we did before the inspection

Prior to our inspection we looked at all the information we held about the service. This included any concerns, investigations or feedback. We also checked the statutory notifications the service is required to send to us by law. The provider did not complete the required Provider Information Return. This is information providers are required to send us with key information about the service, what it does well and improvements they plan to make. We took this into account in making our judgements in this report.

The branch manager told us this was never received by the provider. The location had moved address since the last inspection and had failed to notify the Care Quality Commission (CQC). We were told by the branch manager that the email address supplied to the CQC was not checked regularly for incoming mail. We used a planning tool to collate all this evidence and information prior to visiting the service.

During the inspection

Due to the two people who used the service being unable to communicate with us we spoke with their relatives. We reviewed a range of records. This included two people’s care records and their medication records. We looked at two 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. We also spoke with two staff members and the branch manager.

Updated 18 July 2019

About the service

Key Care & Support Limited is a domiciliary care service, which provides support for both children and adults in the community, who require assistance with personal or nursing care. At the time of this inspection two adults were receiving personal care provided by Key Care & Support.

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

The provider had not ensured health care risks had been appropriately managed. Although staff understood where people required support to reduce the risk of avoidable harm, the care records did not contain explanations of the control measures to keep people safe. New staff had been recruited carefully and the consistency of staff teams helped to ensure people were safeguarded against abusive situations. Medicines were managed well and the staff team were trained in the prevention of cross infection.

People’s interests were documented within the care files and their likes and dislikes were recorded well. However, we recommend the provider obtains more detailed information about how people’s needs are to be best met before a package of care is arranged. The staff team were trained, but we recommend the provider makes improvements around end of life care and the formal supervision of staff.

People were not supported to have maximum choice and control of their lives, which was in their best interests. This was because care records we saw did not demonstrate the Mental Capacity Act was being followed or decisions were being made in people’s best interests. However, relatives told us staff supported people in the least restrictive way possible and the policies and systems in the service supported this practice.

Systems were in place for the management of complaints. People were treated with kindness by a caring staff team and their privacy and dignity was consistently respected. However, the provider had failed to ensure people’s care was properly planned and therefore person-centred care was not always being provided.

There was little oversight of the service and a robust system for assessing and monitoring the quality of service provided had not been established. Therefore, there were significant failings within the governance of the service, which resulted in the well-led domain being rated as Inadequate.

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

Why we inspected

This was a planned inspection based on the previous rating.

The last rating for this service was good (Published 6 December 2016). Since this rating was awarded the service has moved premises. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on our findings at this inspection. We have found evidence that the provider needs to make improvements. Please see the sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Key Care & Support Limited on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment, need for consent, person-centred care and good governance at this inspection.

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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.