Youth Graces UK Limited

Youth Graces UK Limited is a domiciliary care service providing personal care and support to people living in their own homes. At the time of our inspection, there were 59 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

The service had safeguarding procedures in place. Appropriate recruitment checks had taken place before staff started work and there were enough staff available to meet people’s care and support needs. Risks to people had been assessed to ensure their needs were safely met. The service had procedures in place to reduce the risk of infections. People’s medicines were managed safely.

People’s care and support needs were assessed before they started using the service. Staff were supported through induction, training, supervision and appraisals. 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. People were supported to maintain a healthy balanced diet and had access to health care professionals when they needed them.

People's privacy, dignity and independence was promoted. People and their relatives told us staff were kind and caring.

People and relatives spoke positively about the quality of service they received. People received person centred care which met their needs and preferences. The service had a complaints procedure in place.

There were systems in place to monitor the quality and safety of the service. The service worked in partnership with health and social care providers to plan and deliver an effective service. The service took the views of people and their relatives into account to drive improvements.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 19 November 2020) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Youth Graces UK Limited is a domiciliary care service providing personal care and support to people living in their own homes primarily in the London Borough’s of Lambeth and Bexley. The service was supporting approximately 90 people at the time of our inspection.

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

Risks to people had not always been assessed and guidance was not always in place for staff on how to manage risks safely. The provider’s system for receiving, investigating and responding to complaints was not operated effectively. Whilst improvements had been made to the systems used to monitor the quality and safety of the service, not all of the provider’s quality assurance systems were effective in identifying issues of driving improvements.

Staff received infection control training and had access to the personal protective equipment (PPE) they needed to reduce the risk of the spread of infection when supporting people. However, improvement was required to ensure all staff consistently used PPE in accordance with national guidelines. People received safe support to take their medicines, although improvement was required to address shortfalls in the maintenance of records relating to medicines administration. The service employed sufficient staff to meet people’s needs but improvement was required to ensure people consistently received support at the times they had agreed with the provider.

People were protected from the risk of abuse because staff received safeguarding training and were aware of the procedures for reporting abuse. The provider followed safe recruitment practices. Staff were supported in their roles through regular training and supervision. People’s needs were assessed, and they were involved in the planning of their care. They had care plans in place which reflected their individual needs. Staff were aware of people’s care preferences.

The registered manager demonstrated an understanding of the responsibilities of their role. They held regular staff meetings to share key information about the running of the service with staff. The provider sought people’s views on the service through quality assurance checks and the use of surveys. Staff spoke positively about the working culture of the service.

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

Rating at last inspection (and update)

The last rating for this service was inadequate (published 14 May 2020) and there were five breaches of regulations. At this inspection we found the provider had made improvements although they were still in breach of three regulations.

This service has been in Special Measures since 3 December 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions ‘Is the service safe?’, ‘Is the service effective?’, ‘Is the service responsive?’ and ‘Is the service well-led?’ which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.

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

Enforcement

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 have identified breaches in relation to safe care and treatment, receiving and acting on complaints and good governance 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 for 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.

Youth Graces UK Limited is a domiciliary care service providing personal care and support to people living in their own homes. The service was supporting 193 people at the time of our inspection.

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

Risks to people had not always been assessed, and people’s care plans did not always include information for staff on how to manage risks safely. Medicines were not always safely managed. Staff were not always deployed in ways which safely met people’s needs. Accident and incident information had not always been reviewed for learning, to reduce the risk of repeat occurrence. The registered manager had not always submitted notifications to CQC when needed, in line with regulatory requirements.

People’s needs had not always been assessed by the provider to help inform their care planning. Staff had not always received training in areas relevant to the needs of the people they supported. The provider’s quality assurance processes did not always identify issues and failed to drive service improvements. People did not always have care plans in place which reflected their individual needs and preferences. We received mixed feedback from people as to whether they had been involved in the planning of their care, although they also told us they received personalised support from staff.

Improvement was required to ensure people were always supported to have maximum choice and control of their lives and staff always supported them in the least restrictive way possible and in their best interests. People knew how to make a complaint. The provider maintained a complaints log although improvement was required to ensure this captured the details of all of the issues raised by people.

People were supported to maintain a balanced diet, although improvement was required to ensure their care plans contained information about their dietary support needs, where appropriate. People were protected from the risk of abuse because staff were aware of locally agreed safeguarding procedures. However, further improvement was required to ensure the provider’s whistle blowing policy identified external agencies that staff could contact if they had concerns. Improvement was also required to ensure the provider’s recruitment procedures were consistently followed.

People were protected from the risk of infection. They had access to a range of healthcare services when required and received staff supported to attend appointments if needed. Staff treated people kindly. They involved people in decisions about their support. People’s privacy was respected, and staff supported them to maintain their independence. The registered manager told us they would work with other agencies to ensure people received effective care at the end of their lives. Staff spoke positively about the support they received from the management team.

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 17 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified five breaches in relation to safe care and treatment, staffing, person-centred care, good governance and the notification of incidents.

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 for 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.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Youth Graces UK Limited is a domiciliary care service that provides a service for people in the London boroughs of Southwark. Lambeth and Bexley. The services offered include domestic and personal care, escort services, reablement and end of life care. The office is located in Beckenham.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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 and associated Regulations about how the service is run.

This is the first inspection since the agency moved premises.

People were satisfied with the agency and service it provided. They were given notice of any changes to staff and the timing of their care, unless it was unavoidable short notice. The agreed tasks were carried out to their satisfaction and the staff team were thoughtful and really cared. People thought the service provided was safe, effective, caring, responsive and well led.

People’s records, those of staff and other records were kept up to date and covered all aspects of the care and support people received, their choices and identified that their needs were met. Information was clearly recorded, fully completed, and regularly reviewed enabling staff to perform their duties to a high standard.

Staff spoken with were knowledgeable about the people they gave support to and the way people liked to receive support. When required they also worked well as a team, in instances such as calls that may require two staff members. The care and support staff provided was delivered in a professional and friendly way that was focussed on the individual. Their attitude made them approachable and accessible to people using the service and their relatives and they had appropriate skills to achieve this.

People who use the service and parents of younger adults said the manager, management team and organisation were very accessible, supportive, responsive, encouraged feedback and selected and provided a high calibre of staff that were well trained and gave an excellent quality of service. Staff said that they received excellent support and training from the manager and organisation, the organisation was a great place to work and they got a lot of satisfaction from the job they did. They said the management team was approachable, receptive to their ideas and there were opportunities for career advancement. The organisation also provided a number of support services in the community for people with dementia, carers and children.

People using the service and parents were encouraged to discuss health and other needs with staff and had agreed information passed on to GP’s and other community based health professionals, as appropriate. People were protected by staff from nutrition and hydration associated risks by them giving advice about healthy food options and balanced diets whilst still making sure people’s meal likes, dislikes and preferences were met.

The agency staff were familiar with the Mental Capacity Act and their responsibilities regarding it.

The manager, management team, office staff and organisation frequently monitored and assessed the quality of the service provided.