Superb Healthcare

Updated 3 May 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

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 homes.

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 the nominated individual and a director of the provider group. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because the service is small 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 14 March 2023 and ended on 3 April 2023. We visited the site office on 14 March 2023. The registered manager was on leave and some material was unavailable to be reviewed. We revisited the site office on 20 March 2023, on the registered manager’s return from leave to review this material. We returned on 22 March 2023 to review further staff files not made available on 20 March 2023.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We reviewed notifications and information we had received about the service since the last inspection. We sought feedback from the local authority quality assurance and safeguarding team, and other professionals who work with the service. We checked information held by Companies House and the Information Commissioner’s Office. We checked for any online reviews and relevant social media, and we looked at the content of the provider’s website. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.

During the inspection

We spoke with 6 people who use the service and 4 relatives of different people. We spoke with 10 staff including the registered manager (nominated individual/company director), the deputy manager (company secretary), 2 field care coordinators (company directors) and 6 support workers.

We reviewed a range of documents, including people’s care records and daily notes We looked at 18 staff files in relation to recruitment, staff training and supervision. These included the most recently appointed staff within the service. A variety of records relating to the management of the service were reviewed, including the provider’s policies, procedures, accidents and incidents and quality assurance audits.

After the site visit, we continued to seek clarification from the registered manager to validate evidence found and received additional documents and information to inform our inspection. We received feedback from 4 health and social care professionals who engaged with the service.

Updated 3 May 2023

About the service

Superb Healthcare is a domiciliary care agency. The service provides support to older people, younger adults, people living with physical disability, dementia, mental health needs, sensory impairment and the misuse of drugs and alcohol. Staff provide personal care to people living in their own homes and supported living settings. 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. At the time of the inspection 18 people using the service were receiving personal care, supported by 28 staff.

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

The provider could not provide required documentation to demonstrate there were enough staff to meet people’s needs safely. Whilst staff always sought consent before delivering people’s care, records did not show consent to their care had been sought in accordance with the Mental Capacity Act. Care plans did not contain required information in line with the Equality Act 2010, to enable staff to provide person-centred care. Records did not demonstrate people and relatives’ involvement in their care planning. The registered manager had not identified breaches of regulation in relation to staffing, the need for consent and person-centred care planning, which exposed people to potential risk of harm.

People were not 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 support this practice.

People were protected from avoidable harm and experienced safe care from suitably recruited staff, who had been trained to recognise different types of abuse. Staff promoted people’s independence whilst effectively mitigating risks to keep them safe. People were supported to take their prescribed medicines safely by staff who prompted and reminded them, in line with their medicines support plans. People were protected from the risk of infections because staff delivered care in accordance with the provider’s infection prevention and control policy. The management team analysed accidents and incidents to identify and implement required learning.

People's needs were assessed before they received care to ensure their support needs could be met by the service. People experienced care and support from staff who had been enabled to develop and maintain skills relevant to their role. Staff supported people to eat and drink enough to protect them from the risks associated with malnutrition and dehydration. Staff worked effectively with other health care professionals to effectively access health care services and live healthier lives.

People experienced caring, meaningful relationships with staff who consistently treated them with kindness and compassion. Most people and relatives felt valued by the service and that their opinion mattered. People were treated with dignity by staff who respected their privacy and embraced their diversity and individuality.

The management team promoted a positive culture within the service, where people and staff felt valued, focused on delivering good care. The registered and deputy managers were proactive and responsive, ensuring the service achieved good outcomes for people, their relatives and staff. The management team assumed responsibility when mistakes had been made and understood their responsibilities to inform people when things went wrong. Staff experienced good support from the management team, who were readily available to provide guidance. Staff felt comfortable to voice concerns, which they were confident would be addressed. The service collaborated effectively with other agencies, including occupational therapists, hospital discharge teams, social workers and other care providers to ensure people experienced good outcomes.

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 (report published 11 July 2022).

At our last inspection we recommended that the provider seek advice and guidance from a reputable source about the development of individualised, person-centred care plans. The provider had failed to make improvements.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement and Recommendations

We have identified breaches in relation to staffing, need to consent, person centred care planning 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.