Topaz Care Services Ltd

Updated 12 April 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

The inspection team consisted of one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. The service did not have a manager registered with the Care Quality Commission. This means that the provider was legally responsible for how the service is run and for the quality and safety of the care provided. There was a manager in post, but the manager’s application process had not been commenced.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider would be in the office to support the inspection. We visited the office location on 17 November 2021.

What we did before the inspection

Prior to the inspection we reviewed information and evidence we already held about this service, which had been collected via our ongoing monitoring of care services. This included notifications sent to us by the service. Notifications are changes, events or incidents that the provider is legally obliged to send to us without delay. This information helps support our inspections.

During the inspection

We spoke with the manager and the operations manager. We contacted the relative of the person receiving care. We also contacted two care workers. We examined records of one person using the service. We also looked at personnel records of two care workers, including details of their recruitment, training and supervision. We reviewed further records relating to the management of the service, including staffing rotas and quality assurance processes, to see how the service was run.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We received information relating to the provider’s governance systems and some care records. This information was used as part of our inspection.

Updated 12 April 2022

About the service

Quality Care Solutions is registered to provide personal care to people in their own homes. At the time of our inspection the service was supporting one person with 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

The service required a manager who was registered with the CQC. We found not enough progress had been made with recruitment.

Whilst the relative of the person receiving care spoke positively of the level of care and support, we found weaknesses in governance arrangements. There was no effective system in place for case tracking and monitoring care records. Whilst this was related to the size of the service, formal quality monitoring systems needed to be fully developed to ensure the provider had proper oversight of the quality and safety of the service.

There was no effective system of reviewing the recruitment agency’s processes and records to ensure the training and qualifications of agency staff remained up to date. We found agency staff to be knowledgeable but relevant records were kept by the agency and were not accessible locally to satisfy the service that agency staff had appropriate skills and experience of providing care.

There were procedures to ensure the right staff were employed to protect people from harm. However, there were no recruitment plans to ensure the service did not continue to use agency staff to meet normal staffing requirements.

Since our previous inspection, care records were more person centred. They contained meaningful information that identified the abilities and the support required. Likes, dislikes and routine had been recorded. A family member told us their relative’s needs were met.

Care workers told us they felt well supported by the management. They told us that they received appropriate on-going or periodic supervision in their role. In addition, they also received spot checks to monitor their performance when supporting the person receiving care.

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. A family member of the person receiving care told us their relatives independence was promoted.

There were systems in place to ensure proper and safe use of medicines. A family member of the person receiving care told us their relative received their medicines on time.

Privacy was respected. Care plans described how the person should be supported so that their privacy and dignity were upheld.

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

Rating at last inspection

The service was unrated at the last inspection because of insufficient evidence (11 September 2020).

Why we inspected

We had concerns in relation to how the service was managed. The service was unresponsive to our queries.

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 will continue to monitor the service.

We identified a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation good governance. Please see the action we have told the provider to take at the end of this report.

Follow up

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