First Class Healthcare Ltd

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.

First Class Healthcare is a domiciliary care agency registered to provide personal care for people who require support in their own home. CQC only inspects the service being received by people provided with ‘personal care’ and help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. This was the first comprehensive inspection since the agency was registered on 11 July 2017. At the time of our inspection, the service was supporting 11 elderly people.

The provider was also the registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The provider understood their responsibilities under the Deprivation of Liberty Safeguards. People’s capacity to consent to care and support had been assessed and recorded within their care plans.

The provider had suitable processes in place to safeguard people from different forms of abuse. They knew what their responsibilities were in relation to keeping people safe from the risk of abuse. The provider and staff recognised the signs of abuse and what to look out for. There were systems in place to support staff and people to stay safe.

The provider and care co-ordinator involved people in planning their care by assessing their needs on their first visit to the person, and then by asking people if they were happy with the care they received. There was a strong emphasis on person centred care. People were supported to plan their support and they received a service that was based on their personal needs and wishes. The service was flexible and responded positively to changes in people’s needs. Some people were supported by their family members to discuss their care needs, if this was their choice to do so. People told us they were able to express their opinions and views and were encouraged and supported to have their voices heard.

People were supported with meal planning, preparation, eating and drinking as necessary. Staff supported people, by contacting the office to alert the provider to any identified health needs so that their doctor or nurse could be informed.

Staff provided caring and considerate support and respected people’s privacy and dignity.

At this time, the service did not provide care and support to people who were at the end stages of life.

The provider had followed effective recruitment procedures to check that potential staff employed were of good character and had the skills and experience needed to carry out their roles.

The provider deployed sufficient numbers of staff to meet people’s needs and provide a flexible service.

Staff had received training to enable them to carry out the duties they were employed to perform. All staff received induction training at the start of their employment. Refresher training was provided at regular intervals.

Staff received regular supervision and an annual appraisal so they were supported to carry out their roles.

Staff followed an up to date medicines policy issued by the provider and they were checked against this and assessed by the provider. Management systems were in use to minimise the risks from the spread of infection. Staff received training about controlling infection and had access to personal protective equipment like disposable gloves and apron’s.

People said that they knew they could contact the provider at any time, and they felt confident about raising any concerns or other issues.

The provider had processes in place to monitor the delivery of the service. As well as talking to the provider at spot checks, people could phone the office at any time, or speak to the person on duty for out of hours calls. People’s views were obtained through meetings with the person and meetings with families of people who used the service. The provider checked how well people felt the service was meeting their needs.

People felt that the service was well led. The provider and care co-ordinator demonstrated strong values and a desire to learn about and implement best practice throughout the range of services provided. There were systems and processes to enable lessons to be learner and improvements made if things went wrong. Staff were motivated and proud of the service. The provider had developed effective links with organisations that helped them develop best practice in the service. The provider used effective systems to continually monitor the quality of the service.