Background to this inspection
Updated
19 April 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.
Service and service type
Sunshine Care Agency 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.
Notice of inspection
We gave the provider a few days’ notice because we were aware they were a small service and we needed to ensure they would be available to assist us with the inspection.
Inspection activity started on 22 February 2023 and ended on 11 March 2023. We requested a range of documents related to people’s care that was sent to us by the registered manager between 22 and 25 February 2023. We visited the office location on 28 February 2023 to see the registered manager and to review further records related to the service. We made calls to one person who used the service, another person’s relative and care staff between 27 February 2023 and 2 March 2023. We also spoke with one health and social care professional who had experience of working with the service.
What we did before the inspection
We reviewed information we had received about the service since their registration. The provider was not asked to complete a recent 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 reviewed information from a direct monitoring activity (DMA) that was carried out with the provider in September 2022 to get an update on the service. We used all of this information to plan our inspection.
During the inspection
We reviewed records related to 2 people’s care and support. This included people’s care plans, risk assessments and 2 staff files in relation to recruitment, training and supervision. We also reviewed records related to the management of the service, which included daily care logs, quality assurance records and samples of team meeting minutes.
We spoke with 5 staff members. This included the registered manager, the training manager, 2 care workers and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We spoke with one person who used the service and one relative.
We continued to seek clarification from the provider to validate evidence found. We looked at further training records and a range of policies and procedures.
We provided formal feedback to the management team via email on 10 March 2023.
Updated
19 April 2023
About the service
Sunshine Care Agency is a domiciliary care agency. It provides personal care to people living in their own homes.
At the time of the inspection the provider was supporting two people with personal care.
Both people’s care was funded through a local authority direct payment agreement. A direct payment is the amount of money that the local authority has to pay to meet the needs of people and is given to them to have control and choice over who they choose to provide their care.
People’s experience of using this service and what we found
Whilst risks to people's safety were assessed, control measures and clear guidance for staff to follow to manage these risks were not clearly recorded to highlight how people could be supported safely.
Although the issues we found did not directly impact the level of care and support people received, improvements were needed in the level of detail within people’s care plans and risk assessments. This included areas such as diabetes management, communication and decision making.
There were monitoring and auditing systems in place to identify any issues with the quality of the service. Due to the size of the service, formal records were not always kept. However, people, their relatives and staff confirmed there were regular checks across the service.
People and their relatives were happy with how their care and support was being delivered and felt staff had a good understanding of their needs to help keep them safe. One person said, “This support makes a big difference to me, it is very person centred and makes me feel like an individual.”
People and their family members benefitted from having regular staff who spoke their first language to help communication and to understand their cultural needs.
Staff had been introduced to people and completed observations to help them understand how people liked to be cared for and to make them feel comfortable before starting care.
People were supported by staff who told us they enjoyed working for the organisation, felt valued and spoke positively about the supportive working environment.
People and their relatives were positive about the management of the organisation and told us the management team were approachable, flexible and went above and beyond in the support they provided.
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 statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The service was registered with us on 29 October 2020 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement and recommendations
We have identified a breach in relation to safe care and treatment.
We have made two recommendations about how people’s communication needs are recorded and ensuring capacity assessments are completed in line with best practice.
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.