We carried out a review of the data available to us about Simplified Staffing Limited Highland House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Simplified Staffing Limited Highland House, you can give feedback on this service.
Simplified Staffing Limited is a domiciliary care agency providing personal care to people living in their own homes. At the time of our inspection 25 people were receiving personal care at home from this provider. The Care Quality Commission (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.
People’s experience of using this service and what we found
People and their relatives were positive about the quality and safety of the care they received from this home care agency. People agreed the service was now moving in the right direction and had significantly improved in the last 12 months since our last inspection. Typical comments included, “At first, we found there were problems with staff not turning up however, we feel the new managers have turned things around” and “We had a ‘bumpy ride’ to begin with, but my [family member] is now much happier. We feel they are very safe and well cared for by this much improved, much better managed home care agency.”
At our last inspection we found the provider had failed to ensure staff call visits were well-coordinated, new staff were safely recruited and their oversight and scrutiny systems were effectively managed.
At this inspection we found enough improvements had been made. People now received consistently good-quality and safe personal care from the same group of staff who were familiar with their needs and knew how to manage risks they might face. The fitness and suitability of prospective new care staff was now thoroughly assessed and checked. Since the provider had introduced a range of electronic systems to monitor staffs time keeping, their record keeping and medicines management and created a new quality assurance and compliance manager role to oversee the effectiveness of the providers new governance practices the quality and safety of the service people received had significantly improved. People were also complimentary about the way the office-based managers and staff now ran the service, and how approachable they all were.
People continued to be protected against the risk of avoidable harm by staff who knew how to keep them safe. Medicines systems were well-organised, and people received their prescribed medicines as and when they should. People were confident any concerns they raised would be listened to and dealt with appropriately. Staff followed current best practice guidelines regarding the prevention and control of infection including, those associated with COVID-19. 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.
Complaints, concerns, accidents, incidents, and safeguarding issues were appropriately reported, investigated, and recorded. The provider promoted an open and inclusive culture which sought the views of people, their relatives, and staff. People had up to date, detailed, person-centred care plans in place, which were routinely assessed, monitored, and reviewed. Staff had the right levels of training and support to deliver safe care to the people they supported. People were treated with dignity and respect by staff who they typically described as “kind” and “caring.” The provider worked in close partnership with other health and social care professionals and agencies to plan and deliver people's packages of care at home.
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 (published 10 May 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 and the provider was no longer in breach of regulations.
Why we inspected
We conducted an announced comprehensive inspection of this service on 24 March 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve how they coordinated staff call visits, managed staff recruitment and operated their oversight and scrutiny systems.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe and well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Simplified Staffing Limited on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect. If we receive any concerning information, we may inspect sooner.
Simplified Staffing Limited Highland House is a domiciliary care service which provides personal care to people in their own homes. The service provides support to adults with a range of support needs. At the time of our inspection there were 47 people using the service. 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.
People’s experience of using this service and what we found
People did not always receive a service that was safe, as people’s medicines were not always administered and recorded in line with good practice. People did not always receive care and support from sufficient numbers of staff to keep them safe and meet their needs. Incidents and accidents were not always fully investigated.
The nominated individual had failed to ensure effective oversight and monitoring of the service. People did not receive a well-led service that identified issues swiftly, to minimise the impact on them. Records were not always easily accessible.
People were protected against identified risks. Staff knew how to identify, respond to and escalate suspected abuse. Staff followed best practice guidelines regarding COVID-19 and the prevention and control of infection.
People received support from staff that underwent training to enhance their skills and knowledge. Staff received an induction upon commencing their role. People’s health and wellbeing was regularly monitored and where concerns were identified, healthcare services were notified.
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 treated with compassion and kindness and had their diverse needs catered for. Staff were aware of the importance of maintaining people's dignity and respecting their faith and cultural needs.
People’s care was planned, monitored and personalised to meet their needs. Care plans were comprehensive. People’s communication needs were met. Official complaints were recorded and investigated to reach a positive outcome.
Since the last inspection a new manager had been appointed. The manager had identified some of the issues found during the inspection, was knowledgeable and keen to ensure continuous learning and improvement. The manager was aware of their responsibilities in line with legislation and endeavoured to work in partnership with stakeholders.
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 3 January 2020).
Why we inspected
The inspection was prompted in part due to concerns received in relation to staffing levels, unskilled staff and staff employed not having the right to work within the UK. A decision was made for us to inspect and examine those risks.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Simplified Staffing Limited Highland House on our website at www.cqc.org.uk.
Enforcement and Recommendations
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 and will take further action if needed.
We have identified breaches in relation to staffing and governance and oversight of the service. Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
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.
Simplified Staffing Limited Highland House is a domiciliary care agency providing personal care and support to 31 people living in their own homes at the time of the inspection.
All 31 people using the service were receiving 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.
People’s experience of using this service and what we found
The agency was safe for people to use and staff to work in. People were able to live safely and enjoy their lives through the support they received. This was because risks to people were assessed and monitored. The agency reported, investigated and recorded accidents and incidents and safeguarding concerns. There were appropriate numbers of staff available to meet people’s needs. People’s medicine was safely administered by trained staff.
People said they had not encountered discrimination by the agency and their equality and diversity needs were met. The staff were well-trained, supervised, and appraised. People and their relatives praised the way staff provided care that met their needs. People said staff spoke to them in a clear way and at a pace that they could understand and explained things to them including their choices. Relatives said that staff patiently repeated information, to people with dementia, as many times as was required for them to understand.
Staff encouraged people to discuss their health care needs and these were shared with appropriate community-based health care professionals; with people’s permission. The agency had a well-developed professionals' network, which enabled seamless joined up working between services based on people’s needs, wishes and best interests. This included any required transitioning to different services if people’s needs changed. Staff protected people from nutrition and hydration risks, and people were encouraged to choose healthy and balanced diets that also met their likes, dislikes and preferences.
People and their relatives told us they liked the way staff provided care and support for them. Staff attention to small details made all the difference. Staff acknowledged and respected people’s privacy, dignity and confidentiality. People were encouraged and supported to be independent and do things for themselves, to promote their self-worth and improve their quality of life. Staff cared about the people they provided a service for and the way they provided it.
People had their needs assessed, reviewed and received person-centred care. They were given choices, supported to follow their routines, interests and hobbies and social isolation was minimised. People were given enough information to make their own decisions and end of life wishes were identified, if appropriate. Complaints were recorded and investigated.
The agency culture was open, honest and positive with a transparent management and leadership style. The vision and values were clearly defined, understood by staff and followed. Areas of responsibility and accountability were identified, with staff happy to take responsibility on the ground and report any concerns they may have in a timely manner. The agency reviewed service quality and made changes to improve the care and support people received. Audits were carried out and records kept up to date. Registration requirements were met.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered on 14 December 2018 and this is the first inspection.
Why we inspected
This was a planned 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.