Best Solutions Health Care Ltd

Best Solutions Health Care Ltd is a domiciliary care agency and provides personal care and support to people who require assistance in their own home. At the time of our inspection there were 3 people being supported by the service.

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 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

Systems in place did not safeguard people from the risk of abuse. Risks to people were not adequately assessed to keep them safe. medicines were not safely managed. Medication administration charts were not audited, and action was not taken to address errors promptly. Policies and procedures were in place to guide staff around infection prevention. Staff did not always wear appropriate PPE to reduce the risk of the spread of infection. Incidents and accidents were not monitored to ensure action was taken to keep people safe.

People's needs and choices were not recorded to give staff appropriate guidance to care for them. Staff did not always receive sufficient training to help them carry out their roles. Multiple training topics were covered in one day, meaning staff were not provided with enough time to develop their learning.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Complaints were not appropriately addressed. Records did not reflect complaints the service had received or what action had been taken as a result.

The registered manager did not have an adequate understanding of their role or the regulatory requirements. There was a lack of service oversight and the registered manager did not ensure that there were effective governance systems in place, with no audits and quality control. Policies and procedures did not provide staff with clear guidance and had not been reviewed to ensure they were up to date.

People told us that staff were kind and caring towards them, but staff did not promote their privacy and dignity. Staff told us they were supported but there were no records to show they had received an induction, supervision or that their practice had been checked. Staff told us they felt the registered manager was approachable and they felt supported in their roles.

Staff were recruited safely, and people told us staff were kind and caring. Staff were recruited safely. Where people required support with eating and drinking, people told us staff supported well in this area.

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 with us on 07 December 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. We carried out an inspection to give the provider a rating.

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 monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment, staffing, person centred care, good governance, safeguarding people from abuse, and consent at this inspection.

Please see the action we have told the provider to take at the end of this report. 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 work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

This inspection started as an ‘inspection using remote technology’. This means we used technology such as electronic file sharing to gather information, and phone calls to engage with people using the service as part of this performance review and assessment. However, the registered manager did not provide all of the documents requested during the inspection; therefore, we also visited the location’s office to gather this information, but we were told the office had moved location.