Step One Services

Updated 4 March 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection was conducted by 1 inspector.

Service and service type

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

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 24 hours’ 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 the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 1 person using the service and 1 person’s relative. We spoke with 7 members of staff including the registered manager, deputy manager and quality and compliance manager. We sought feedback from 3 health professionals and received feedback from 2. We reviewed 2 people’s care plans and 2 staff recruitment files. We reviewed quality assurance processes and records and sampled staff training records.

Updated 4 March 2023

About the service

Step One Services provides care and support to people with a wide range of needs who live in their own homes in the Newton Abbot area. The services provided include a day center and enabling service as well as assistance with 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. At the time of the inspection the service was providing personal care to 2 people.

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

Right Support:

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. People were supported in their own homes and were actively supported to live their lives in the way they wanted to, including being spontaneous about how they spent their day.

Right Care:

Risks to people’s health and wellbeing were assessed and monitored. Staff worked with people and other health professionals to manage risks and to ensure people were supported to remain as independent as possible. Records relating to people and staff’s safety were kept and reviewed to ensure any patterns were identified, and lessons learnt. People received their medicines safely. Systems were in place to ensure people were safeguarded from the risk of abuse and staff understood how to raise concerns and had done so appropriately. Staff were recruited safely and there were enough staff to meet people's needs.

Right Culture:

Staff and health professionals told us the culture of the service was open, caring, and focused on empowering people. People’s care plans reflected how important their independence was to them. Staff told us that the registered manager and office staff were very supportive. One said, “It’s like a family, they really look after their staff.” Managers reviewed the care people were receiving on a daily basis and analysed alerts about missed care or incidents over a longer period of time to identify any patterns or trends. Thematic audits were completed where appropriate. The registered manager was committed to continuously learning and improving the service. They had recently volunteered to work with the local authority to complete a provider assessment which analysed the quality and safety of the service. A health professional told us they were responsive to feedback given and proactive in implementing improvements. Systems were in place to record any complaints. There had been no complaints in the previous 12 months.

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 (11 July 2019).

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.

At our last inspection we recommended that the provider reviewed their medicines administration auditing processes to ensure safe medicines administration at all times. We also recommended that the service records any lessons learnt and carried out a monthly analysis to look for patterns and trends to mitigate risks and learn from mistakes. At this inspection we found improvements had been made.

Why we inspected

We carried out a comprehensive inspection of this service on 22 and 23 May 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve assessment and mitigation of risk and ongoing monitoring to improve the quality and safety of the service.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. 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 Step One Services on our website at www.cqc.org.uk.

Follow up

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