Archived: Quintessential Support Brokers

Updated 23 January 2020

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

The inspection team was made up of one inspector and one inspection manager.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes.

The service has a manager registered with CQC, who is also the nominated individual for the provider organisation. A nominated individual is a person who is responsible for supervising the management of the service on behalf of the provider. As well as the registered manager of the service also being the nominated individual, they are also the only director of the provider organisation. This means they alone are legally responsible for how the service is run and for the quality and safety of the care provided. In this report, due to the person's multiple roles, we will refer to them as the registered person. The registered person had also employed a new manager, who was assisting the registered person to develop and implement systems to improve the service.

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 registered person would be in the office to support the inspection.

Inspection activity started on 11 December 2019 and ended on 13 December 2019. We visited the office location on 11 December 2019.

What we did before the inspection

We looked at all the information we had collected about the service. This included previous inspection reports, information received and information about important events the registered person and others had sent us. We used all of this information to plan our inspection.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with the registered person and the new manager. We looked at the care plans for both people who use the service, plus associated monitoring records and medicine sheets. We also looked at three staff recruitment files, staff training records and the staff supervision log. We reviewed a number of other documents relating to the management of the service. For example, improvement plans, staff meeting minutes and audit records.

After the inspection

We reviewed the additional information the registered person sent to us after the visit at our request. We sought feedback from all seven care staff and received responses from five. We were not able to speak directly with the people using the service but, with permission, we contacted relatives who gave their feedback on the quality of the care. We sought feedback from three community professionals but had received no response at the time of writing this report.

Updated 23 January 2020

About the service

Quintessential Support Brokers is a domiciliary care service registered to provide personal care to people in their own homes. At the time of this inspection they were supporting two people with personal care. Not everyone using Quintessential Support Brokers receives a regulated activity. The Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’, which is help with tasks related to personal hygiene and eating.

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

At the last inspection in April 2019 we found there were breaches of seven regulations. At this inspection we found the registered person had taken positive steps and implemented systems to improve the quality and safety of the service provided. The registered person told us they had concentrated on building solid foundations for the business before offering care to new people and increasing the care provision. Our findings demonstrated that the steps taken, and systems put in place were being successful. This meant that the ratings for all five key questions and the overall rating for the service has improved at this inspection. However, some of the systems were very new and we could not improve the ratings to higher than requires improvement in some key questions. This was because not all systems had been in place long enough to evidence consistent good practice over time. The registered person and new manager were clear on improvements that were still needed and had well thought out plans in place to address them. We will check that improvements made have been sustained at our next planned comprehensive inspection.

Staff recruitment had improved, and the registered person introduced a new checking system as a result of some discrepancies identified at this inspection. Improvements to the safety of people meant they were protected from the risks of abuse and relatives felt their family members were safe with the staff providing their support and care. Risks to people’s personal safety had been assessed and plans were in place to minimise those risks. Staffing levels supported people to stay safe while living as independent a life as possible.

The registered person and new manager had introduced new systems for overseeing the quality and safety of the service. The new systems were helping the registered person monitor their compliance with the regulations and registration requirements and identify where they needed to make improvements. We saw at the inspection that the monitoring systems were being adapted and improved as a result of any issues that were not identified by the systems in place. For example, the new manager amended the audit tool for checking staff recruitment was compliant the day after we identified issues with some staff checks at this inspection.

Staff training had been improved and people received effective care and support from staff who knew them well. People received effective health care and support where needed. The handling of medicines had been improved. Staff training, and staff competency checks. had been introduced for all staff handling medicines so that medicines were handled correctly and safely. People's rights to make their own decisions were protected. They 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; the policies and systems in the service supported this practice.

People benefitted from staff who were happy in their work and felt well managed and supported. People were treated with care and kindness. They were consulted about their care and support and could change how things were done if they wanted to. People were treated with respect and their dignity was upheld. This was confirmed by relatives who provided feedback. Methods to protect personal data had been improved meaning people's right to confidentiality was protected.

A new electronic care planning system had been introduced. The registered person and new manager had re-assessed both people who use the service and recorded in depth information regarding their care needs, preferences and wishes. People received care and support that was personalised to meet their personal care needs and their diverse needs were identified and met. Staff worked well together for the benefit of people and were focused on the needs of the people using the service.

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 inadequate (report published 25 June 2019) and there were multiple breaches of regulations. At this inspection we found the registered person had made improvements and the provider was no longer in breach of regulations in relation to the service provided to the two people who currently use the service.

This service has been in Special Measures since 24 June 2019. During this inspection the registered person demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

At the last inspection we identified that the provider had failed to notify us of incidents which were reported to, or investigated by, the police. This was a breach of regulation and we issued a fixed penalty notice. The provider accepted a fixed penalty and paid this in full.

Why we inspected

This was a planned inspection based on the previous rating of inadequate. As part of this inspection we also assessed whether the provider had taken the actions necessary to meet the regulation breaches identified at the last inspection.

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.