First Practice Healthcare Ltd

First Practice Healthcare is a domiciliary care agency providing personal care to 98 people including children aged 4-18, older and younger adults. People using the service may experience the following; dementia, learning disabilities or autistic spectrum disorder, mental health issues, they may misuse drugs and alcohol, they may have an eating disorder or have a physical or sensory impairment.

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

Risk assessments were not always detailed and person centred, in particular to ensure people and staff were kept safe. Records were not always kept appropriately. Recruitment was not always carried out in a safe manner. Some people told us that staff did not always arrive on time, others were happy with the timings of calls. Incidents and accidents were dealt with, although it was not always clear if or what follow up action had been taken. Personal Protective Equipment (PPE) was used as required with the exception of a small number of concerns raised. Medicines were given appropriately and records for their administration were kept as required.

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.

Initial information gave a good overview of the person but did not always detail information on care required and how conditions could be improved or managed. However, people told us staff understood their needs. People’s likes and dislikes were considered. People’s life history was acknowledged. Staff received appropriate training to assist them in their role. People told us they were supported to eat and drink without issues.

There was a mix of opinion about staff members attitude towards people. Some felt it was caring and supportive, whilst others felt it was abrupt and rushed. People told us their privacy and dignity was managed well during the care they received. People’s decision making was promoted.

There was inconsistency in care plans, and some had a higher level of information than others. People had been part of developing their care plan. Feedback was taken from people on a regular basis.

Whilst systems were in place to record complaints, lessons learnt were at times generic and not person centred. Audits did not identify the issues raised during the inspection. Audits did not lend themselves to the easy identification of patterns and trends. People’s preferred communication were used. The service worked with external agencies.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, 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 providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. People were offered choices and encouraged to make decisions on the care they wanted to receive.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This service was registered with us on 19/12/2019 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about the safeguarding of people using the service and the timeliness of notifications received by CQC. A decision was made for us to inspect and examine those risks.

We found evidence the provider needs to make improvements. The overall rating for the service is requires improvement. This is based on the findings at this inspection.

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to good governance. Please see the action we 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.