First Class Healthcare Ltd

Updated 30 October 2021

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 Care Act 2014.

Inspection team

This inspection was carried out by one inspector and an Expert by Experience. 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.

The service had a manager registered with the Care Quality Commission who is also the provider. This means they are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because it was a small service and we needed to be sure the provider, who is also the 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 used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with three people who used the service and 10 relatives about their experience of the care provided. We spoke with four members of staff including the registered manager, deputy manager, and care workers. We reviewed a range of records. This included two people’s care records and medication records. We looked at three 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.

After the inspection

We reviewed evidence requested on inspection relating to staff recruitment, record keeping and the provider’s policies and procedures on safeguarding and infection prevention and control and end of life care. We reviewed staff training and accident and incident records which the provider had updated. We continued to seek clarification from the provider to validate evidence found.

Updated 30 October 2021

About the service

First Class Healthcare is a domiciliary care provider registered to provide personal care to people in their own home. 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. The service was supporting 20 people with personal care on the day of inspection.

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

There were appropriate levels of suitably trained staff to support people with their assessed needs however, we identified staff were working without necessary legal checks to ensure they were suitable to work with vulnerable people. The provider did not have robust recruitment procedures in place to identify these shortfalls.

Records with checking and auditing people’s care and support plans were inconsistent in the level of detail they contained. It was not clear when people’s care packages were reviewed, or if changes identified had been made.

Accident and incidents were reported correctly by staff providing care however, records did not show they had been recorded, investigated or learnt from. Records lacked detail of actions taken as a result.

Feedback we received on the handling of complaints was mixed. Monthly audits of the service were not adequate to ensure that the service is operating safely. Audits and checks provided on inspection had identified the same issues each month with no actions to take or things to do to stop it happening.

People told us that they felt safe and care staff treat them the way they want to be treated, describing staff as cheerful, talkative, caring and dedicated.

One person’s relative told us, “They understand my [relatives] needs. It’s clear they have the skills to meet them also.”

Staff had been trained in protecting people from the different types of abuse. Safeguarding investigations had been completed appropriately and had involved all necessary professionals.

People were supported to have maximum choice and control of their lives and staff them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Care plans and risk assessments involved the person they related to and also people’s representatives appropriately. Care plans were developed with goals and had details of how these were to be achieved.

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 Good (published 17 August 2018). The rating for the service has now deteriorated to requires improvement.

Why we inspected

This was a planned inspection based on the previous rating.

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 have identified breaches in relation to shortfalls with records and recruitment practices 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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.