1st Healthcare Ltd

Updated 3 February 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 one inspector.

Service and service type

This service provides care and support to people living in a ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

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 who was also a director of the company.

Notice of inspection

We gave the service 48 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.

Inspection activity started on 3 October 2022 and ended on 13 October 2022. We visited the location’s office on 5 October2022.

What we did before the inspection

We reviewed information we had received about the service during the registration process. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We met the registered manager who was also a director of the company and a service manager. We looked at a range of records which included the care record for one person, three care workers’ files and a range of records including those used for monitoring the quality of the service, such as audits and policies. Following the inspection, a telephone interview was carried out with one relative and we received feedback from three care workers. two people and the relatives of four other people who received care visits.

Updated 3 February 2023

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

1st Healthcare provides a supported living service for adults with a learning disability. At the time of the inspection one person was using the service.

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

The service was able to demonstrate how they were meeting some of underpinning principles of right support, right care, right culture. However, they also needed to make improvements in order to fully meet these.

Right Support:

Risks management plans had not been developed to identify how to mitigate risks associated with the care the person required. People were not always supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. However, staff supported people to take part in activities and pursue their interests in their local area and to interact online with people who had shared interests.

Right Care:

The provider did not always ensure care plans provided accurate information on the person’s current support needs. People’s communication support needs were not always clearly described. Care workers understood how to support a person’s privacy and dignity when providing care. People were supported to maintain their independence by care workers. Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care.

Right Culture:

The provider did not have effective and robust systems in place to monitor the quality of the care being provided. Records about people did not always show respect or understanding of their needs. The provider could not demonstrate that care workers had completed the mandatory training identified as required for their role. Care workers felt supported by the registered manager.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 6 October 2016 and this is the first inspection.

Why we inspected

We inspected the service based on the date of registration with us.

Enforcement and Recommendations

We have identified breaches in relation to person centred care, need for consent, safe care and treatment, staffing and good 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 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.