Background to this inspection
Updated
14 June 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
The inspection was carried out by 2 inspectors 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.
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.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because we wanted to make sure there was someone from the service able to support us in our visit to the office.
What we did before the inspection
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
We sought feedback from the local authority and professionals who work with the service. We reviewed information we held about the service. This included notifications of safeguarding concerns, incidents and accidents.
We used all of this information to plan our inspection.
During the inspection
We spoke with 6 staff. This included the 2registered managers, office staff and care staff. Our Expert by Experience spoke with 3 people who received care from the agency and 4 relatives of people receiving care.
We reviewed the care documentation for 8 people, looked at numerous medicines records and checked the recruitment files for 4 staff. We also looked at other documentation relating to the service. This included training information, minutes of staff meetings, survey results and other governance systems and processes.
Following the inspection, the registered manager sent us requested documentation in relation to training and other aspects of their service. We also spoke with 4 staff and the friend of 1 person who received care from the agency.
Updated
14 June 2023
About the service
Fairolive is a care agency, providing care to people living in their own homes. In total at the time of our inspection, Fairolive provided care to 58 people. 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. Fairolive had a satellite office located in Sussex. The care provided to people in that location was managed by the main office. At the time of our inspection, 48 people received the regulated activity of personal care.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.
People’s experience of using this service and what we found
Right Support:
People were encouraged with their independence and enabled to make their own decisions around their 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; the policies and systems in the service supported this practice.
People were provided with food appropriate for their needs and staff worked with external professionals to ensure people received health care when they needed it.
People were supported by staff who were able to recognise potential signs of abuse and knew who to report these to. Where accidents and incidents occurred, staff recorded these and appropriate action was taken to help protect people from continued harm.
Right Care:
People were cared for by staff who showed them respect and dignity. People said they had good relationships with staff and staff took time to speak with them.
People had cared plans and they were given the opportunity to be involved in them. People’s preferences were recorded and people said staff knew how they liked their care.
People were supported by staff who went through a robust recruitment process and were trained for their role.
People were cared for by staff who understood their individual risks. Where people had specific health conditions, staff were provided with guidance on how to respond to these.
Right Culture:
Although improvements had been found since our last inspection, management still had further work to do to ensure those improvements were embedded into daily practice to enable them to provide a consistently high-quality service.
People told us staff timekeeping was poor. People and relatives also said they had experienced missed calls.
There was a lack of robust delegation within the service and despite management being aware of national guidance around Right support, right care, right culture, staff had not undertaken training in learning disabilities or autism.
The stability of staffing had improved since we last visited the agency and monthly training sessions on specific topics was being rolled out by management. The agency worked with external health and social care agencies to support people’s care.
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 Requires Improvement (report published 30 March 2022) and there were breaches of regulation.
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found improvements had been made however, the provider remained in breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
Why we inspected
This inspection was prompted by a review of the information we held about this service and to follow up on the shortfalls we found at our last inspection.
Enforcement
We have identified a breach of regulation in relation to good governance within the agency.
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.