Veraty Care Solutions Ltd

Veraty Care Solutions is a domiciliary care service providing personal care to people living in their own homes. At the time of the inspection 51 people were receiving the regulated activity of personal care.

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's medicines records had unexplained gaps in recording and there was limited monitoring or audits of systems to manage people's medicines. This meant people could be at risk of not receiving their medicines as prescribed.

Limited quality monitoring systems were in place, and those that were being used were not fully embedded. This meant the provider had limited oversight of the service which placed people at risk of harm of receiving inconsistent care.

People told us they felt safe when staff supported them, and staff knew how to recognise signs of abuse and how to report any issues.

People were supported by trained staff who had been recruited safely. People were supported in line with government guidance around COVID-19.

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 8 April 2019)

Why we inspected

We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about lack of notifications. A decision was made for us to inspect and examine those risks.

We inspected and found there was a concern with people’s safety around medicines, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe and well-led.

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 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.

People’s experience of using this service:

People were supported by staff that were caring, compassionate and treated them with dignity and respect. The provider listened to people’s concerns and responded to them, using this as an opportunity to improve their service.

People received person centred care and support based on their individual needs and preferences. Staff were aware of people's life history, and their communication needs. They used this information to develop caring relationships with people.

The provider offered a service of flexible support to people and were able to adapt in order to meet people's needs and support them as they wanted.

Staff were recruited in a safe way and there were enough staff to meet people's current needs. Staff were supported by a system of induction, training, one-to-one supervision and appraisals to ensure they were effective in their role.

Staff liaised with other health care professionals to ensure people's safety and meet their health needs. Where people lacked capacity, staff worked with the local authority to make sure they minimised any restrictions on people's freedom for their safety and wellbeing.

The provider worked well to lead the staff team in their roles and ensured people received a good service. Quality checks were in place and used to drive improvement in the service.

The service met the characteristics of Good in all areas; more information is available in the full report below.

Rating at last inspection: Requires improvement (report published 13 February 2018 )

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service was rated Good overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

Veraty Care Solutions Ltd is a domiciliary care agency that provides personal care and support to people in their own homes. At the time of our visit the agency was providing a service to 20 people. The frequency of and duration of visits across the service varied dependent on people’s needs.

There was a registered manager in post who was present during the inspection. 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 2008 and associated Regulations about how the service is run.

At our last inspection in February 2017, we found breaches of Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014. We gave the service an overall rating of ‘requires improvement’. These breaches related to the provider's failure to follow safe recruitment procedures, to ensure good governance and to notify CQC of events that they are required to do so by law. We asked the provider to make improvements and to send us an action plan of how they intended to address the shortfalls in care.

At this inspection we found that some improvements had been made, but further improvements were still required. The provider had failed to fully embed their quality assurance checks and had not identified all the shortfalls we had found during this inspection. Although people and their relatives told us that they were regularly asked whether they were happy with the care put in place to support them, these care reviews were not always recorded. The registered manager told us they observed staff practice to ensure standards of care were maintained, but they did not always record the outcomes of these checks. We found that people's care plans did not always reflect their needs and the support provided by staff. This had not impacted on the care people received because they received support from regular staff that knew them and their needs well.

The provider had failed to conspicuously display their rating for their previous inspection which they are required to do so by law.

Staff were knowledgeable about the different forms of abuse and how they would recognise the signs of abuse. Staff knew who to report concerns to should they become aware of any abuse or poor practice.

People were supported to take their medicine as prescribed. Only staff who had received training in the safe administration of medicine were able to support people to take their medicine. People were supported to access healthcare support as necessary.

People were supported by regular staff who were allocated enough time to meet their needs and travel between calls. Staff usually arrived on time and notified people if they were running late. The provider followed safe recruitment procedures to ensure prospective staff were suitable to work with people in their own homes.

Staff sought people’s consent before they supported them. Staff provided information in a way people could understand to enable them to make their own decisions wherever possible.

People were supported to eat and drink enough. Staff were aware of people’s dietary needs and followed guidance provided by the speech and language therapist.

Staff were positive about the training opportunities available to them and felt well supported by the registered manager and their colleagues.

People were supported by staff who were kind and caring. Staff treated people with dignity and respect and encouraged them to remain as independent as possible.

People and their relatives knew the registered manager and found them easy to talk with. They were asked their views on the quality of the service and felt able to raise any concerns with staff and management should they arise.

You can see what action we told the provider to take at the back of the full version of the report.

Veraty Care Solutions Ltd is a domiciliary care agency that provides personal care and support to people in their own homes. At the time of our visit the agency was providing a service to 19 people. The frequency of and duration of visits across the service varied dependent on people’s needs.

There was a registered manager in post who was present during the inspection. 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 2008 and associated Regulations about how the service is run.

People were placed at risk of harm as the registered manager did not follow safe recruitment procedures.

The registered manager had not fulfilled their regulatory responsibilities as they had not notified us of significant events that they are required to tell us about by law. There was a lack of formal quality assurance systems to drive improvements in the service.

Staff knew how to recognise and report signs of abuse. Risks associated with people’s needs and environment had been assessed and staff knew how to minimise these.

People received consistent support from regular care staff who let them know if they were going to be late. Staff knew people well and were able to recognise changes in their health and support needs.

People were satisfied with the support they received to take their medicines. Only staff who received training on the safe administration of medicine gave people their medicines.

People and their relatives were confident in staff’s knowledge and ability to meet their needs. Staff felt well supported in their roles and received training to meet people’s individual needs.

People were provided with information in way they could understand to enable them to be involved in decisions about their care. Where people were unable to make decisions for themselves these were made in their best interests to protect their rights.

People were supported by staff who were kind and caring. People were given choice and felt listened to. Staff respected people’s privacy and dignity and supported them to remain as independent as possible.

People received support that was individualised to their personal needs and preferences. Staff had formed positive working relationships with people and their relatives. Staff provided a flexible service that was responsive to changes in people’s needs and requirements.

People were asked their views on the quality of care provided and felt comfortable to raise any concerns with staff or management. People, their relatives and staff found the registered manager friendly and easy to talk with.

There was an open and inclusive working culture where staff and management worked as a team to meet people’s needs.

You can see what action we asked the provider to take at the end of the full report.