About the service SNE Care Services Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. 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 our inspection 77 people were receiving personal care from the service.
People’s experience of using this service and what we found
Auditing and oversight of the service were not always robust. We found some issues that the provider’s systems had either not identified or not corrected. The registered manager had planned a range of improvements and had been working hard to deliver these. Some the changes were recent and had not always ensured consistent good practice.
People did not always have their medicines as planned or at the correct times. The medicines audit system did not follow best practice and did not always ensure medicines errors were identified or acted on in a timely way.
The provider had recruitment processes to minimise the risk of unsuitable staff being employed, however we found occasions were references had not been robustly checked to ensure these were from an appropriate source.
Support plans and risk assessments were person centred but staff did not always have clear guidance around all potential risks. Management and senior staff were very knowledgeable about people’s individual needs and staff felt they had enough information to support people safely.
There were enough staff on duty and care was planned to provide consistency of care. There had been some issues with staffing and recruitment due to the impact of Covid-19. Most people and relatives gave positive feedback about the service and the staff who supported them. Some people told us; however, they did not always get consistent care from staff who understood their support needs. The registered manager was recruiting staff and had started some initiatives to lessen the impact of staffing pressures.
People were safeguarded from abuse and the provider had effective infection control procedures in place.
Where concerns were identified, lessons were learnt and shared with staff. The management and staff we spoke with had a clear focus on delivering positive outcomes for people. The service worked with and acted on feedback from partner agencies. The management had sought feedback on the quality of the service from staff, people and relatives to develop the service.
The registered manager acted immediately to address the issues we identified at this inspection and communicated changes and best practice with staff.
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 (24 November 2018).
Why we inspected
We received concerns in relation to the management of medicines, safe staffing and the quality and consistency of people’s care. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
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 good to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led 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 SNE Care Services Limited on our website at www.cqc.org.uk.
Enforcement and Recommendations
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 monitor the service and will take further action if needed.
We have identified a breach in relation to good governance at this inspection. Governance and auditing systems did not always identify and rectify issues in a timely way, particularly in relation to medicines and recruitment.
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 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 continue to monitor information we receive about the service, which will help inform when we next inspect.