Background to this inspection
Updated
4 February 2022
The inspection
We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.
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 carried out by two inspectors.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave a short period of 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.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from partner agencies. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with three relatives of people using the service, five members of staff including the registered manager, deputy manager and support workers. We also sought feedback from two external professionals who worked in collaboration with the service. We reviewed a range of records. This included four people's care records and one person’s medicine records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were reviewed including incidents and complaints, quality monitoring and policies and procedures.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.
Updated
4 February 2022
About the service
Provision Care Limited in Leicester, provides care and support for people in their own homes. The service was supporting 8 people at the time of the 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
There were systems in place to monitor incidents, accidents and safeguarding concerns and staff understood how to report these. Individualised risk assessments were in place, but they lacked detail to ensure safe care. The provider did not carry out safe pre-employment checks in line with organisational policy. Topical medications (creams) and ‘when required’ medicines were not managed safely, and the provider could not evidence staff had been assessed as competent to administer medications.
Support plans were in place but lacked detail on people’s needs. Staff were provided with training, but some training needs had not been identified. People were supported to make their own food and drink choices. There was evidence the provider worked collaboratively with external professionals, but feedback from professionals was mixed.
The provider responded to the views and wishes of people using the service, and feedback from relatives was positive. One relative said, “We’d like to say a big thank you, can’t praise them enough”. Staff told us they protect people’s dignity and they were knowledgeable about the people they support and how to promote independence.
The provider was responsive to people’s changing needs. However, complaints were not recorded, and the registered manager lacked knowledge on their responsibilities in this area. Support plans were found to be lacking information related to end of life care.
Management frequently visited people and delivered care. Staff told us management were approachable and supportive. There was a lack of robust and effective quality assurance processes in place to monitor the quality of the service. Organisational policies were not robust or tailored to the service and the training matrix was not fit for purpose.
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.
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 14 November 2017)
Why we inspected
We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.
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 will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches of regulation in relation to medicines, pre-employment checks, support planning and quality assurance systems 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 continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.