Background to this inspection
Updated
14 December 2022
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
This inspection was carried out by two inspectors and an Expert by Experience who made telephone calls to people and relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
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 we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 6 October 2022 and ended on 21 October 2022. We visited the location’s office/service on 6 October 2022.
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. The provider did not complete the required Provider Information Return (PIR). This is information providers are required to send us annually with key information about the service, what it does well and improvements they plan to make. Please see the Well led section of the full inspection report for further details. We used information gathered as part of monitoring activity that took place on 22 September 2022 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.
During the inspection
We spoke with ten people who used the service and three relatives about their experience of the care provided. We spoke with seven members of staff including the nominated individual, registered manager, care coordinator and care workers. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included seven people’s care records. We reviewed medicines records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
14 December 2022
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
Scott Care's Medway Branch is a domiciliary care agency providing personal care and support for people in their own homes. People receiving care and support were adults, older people and autistic people. At the time of our inspection, 78 people were using the service.
People’s experience of using this service and what we found
The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.
Right Support:
The service did not make reasonable adjustments for people so they could be fully in discussions about how they received support. People received surveys and provided feedback but the service failed to act on these to improve the service.
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.
Staff supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs.
Right Care:
People had not always received care that supported their needs and aspirations, was not focused on their quality of life, and did not follow best practice. Care calls were sometimes late or missed and people were not informed about these changes. This put people at risk of their care needs not being met.
People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing.
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. People benefitted from staff who understood and responded to their individual needs.
Right Culture:
Management failed to effectively evaluate the quality of support provided to people and to fully involve the person, their families and other professionals as appropriate.
People’s quality of life had not been enhanced due to the lack of the service’s culture of improvement and inclusivity.
Staff had not ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.
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 requires improvement (published 26 October 2020). 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 the provider remained in breach of regulations 12 and 17.
Why we inspected
The inspection was prompted in part due to concerns received about poor care provided, care visits timing, missed calls, staffing, complaints, compliance with Mental Capacity Act, incidents and accidents and management. A decision was made for us to inspect and examine those risks.
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 on our website at www.cqc.org.uk.
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.