Just Homes Care

Just Homes Care is a domiciliary care agency providing personal care to older people and people with a learning disability living in their own homes. Just Homes Care also provides care to people with a learning disability in six supported living houses. Not everyone who used the service received personal care. CQC only inspects or reviews 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.

At the time of the last inspection 25 people were receiving care from the service. During this review, 65 people were supported by the service.

Background to this report

At our previous comprehensive inspection at Just Homes Care on 24 and 27 February 2020 we identified concerns relating to well-led. We found that the registered manager had failed to submit statutory notifications in line with their regulatory requirement. This was a breach of Regulation 18: Notification of other incidents, Care Quality Commission (Registration) Regulations 2009) for which we issued a requirement notice. The key question well-led was rated requires improvement and the overall location rating was required improvement.

The full report of that inspection can be found by selecting the ‘all reports’ link for Just Homes Care on our website at www.cqc.org.uk.

Why we carried out this review

We carried out this review on 28 April 2022 to follow-up on the requirement notice and assess whether the provider has addressed the improvements required at our previous inspection. We did this using a ‘desk-based’ review process because evidence to demonstrate that the requirement notice had been met could be obtained and assessed remotely without needing an inspection visit to the location. This was not an inspection: the scope of this review did not include a visit to the service or an assessment of the outcomes for people using the service.

What we found

This report covers our findings in relation to the action taken by the provider to address the requirement notice issued at our last inspection. Details of the findings from this remote assessment can be found under the well-led section of this report.

Through this review we assessed that Just Homes Care has taken action to meet the requirement notice issued after the last inspection. They are therefore no longer in breach of Regulation 18: Notification of other incidents, Care Quality Commission (Registration) Regulations 2009.

Rating at last inspection and update

Following the last inspection, this location was rated requires improvement. Although only the well led key question was rated requires improvement, if there is a breach of a regulation a location cannot be rated higher than requires improvement overall.

Through this review, we have assessed that Just Homes care provided assurance that improvements had been made to address all issues that resulted in the well-led key question being rated requires improvement. This includes an assessment that the service is no longer in breach of Regulation 18 which previously acted as a ratings limiter. The overall rating has therefore improved to Good.

Just Homes Care is a domiciliary care agency providing personal care to older people and people with learning disabilities living in their own homes. Just Homes Care also provides support to people with learning disabilities in six supported living houses. At the time of the inspection the agency was supporting 25 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.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

People and relatives gave positive feedback about the service and staff felt valued. There were systems and processes in place to ensure the quality of the service was continually monitored, where opportunities to improve the service were identified, appropriate action was taken. However, there had been a failure to ensure statutory notifications were submitted in line with their regulatory requirements.

There were systems and processes to safeguard people from the risk of abuse. Person centred risk assessments were in place to reduce the risk of harm. the recruitment of staff was safe, and people were generally supported by a staff team who knew them well. Staff received training in the administration of people’s medicines.

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 achieved good outcomes as their needs were holistically assessed and their care and support was delivered in line with current good practice. New staff were supported, and all staff received regular training and supervision. People were supported, where needed to eat and drink. People had access to other health care professionals.

People were supported by kind and caring staff. Support workers knew people well, they treated people with dignity and respect. People were encouraged to retain their independence and compete tasks themselves where possible.

Care records were person centred and detailed. Records included the support people needed to enable them to communicate. Support workers enabled people to participate in a range of activities which they enjoyed. There was a systemin place to ensure complaints were dealt with appropriately.

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

Rating at last inspection

The last rating for this service was good (published 18 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified a breach in relation to a failure to notify CQC of all incidents that affect the health, safety and welfare of people who use the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

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.

Just Homes Care provides personal care for older people and people with a learning and/or physical disability living in their own homes and in supported living environments. The supported living homes were managed differently as some had staff for a 24 hour period and others relied on the Carelink alarm after 11pm. This arrangement was discussed with all people in these homes prior to implementation and agreed by all relevant parties.

There was a registered manager who had been registered since June 2016 although involved with the service for a longer period. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People felt safe with the staff who supported them and staff had a good understanding of what may constitute abuse and how to report such concerns.

Risks were managed on an individual basis, ensuring people faced a reduced likelihood of harm.

Staffing levels were appropriate and we saw rotas were covered meaning people received support in a timely manner. Medication was administered safely in line with current guidelines and staff were able to explain the procedures well.

Supervision and training was offered to all staff on a regular basis and this was enhanced by observations of their practice. These methods of individual support ensured all staff had a sound knowledge base and the observations demonstrated the learning was implemented.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

We saw people were encouraged to make healthy eating choices where this was in their best interests and staff supported with appropriate pressure care. External agency support was accessed as required and Just Homes Care worked alongside other care agencies in providing joint support packages.

People and their relatives were complimentary of the staff and spoke highly of the support they received. Their privacy and dignity was respected and staff were very aware of the importance of ensuring confidentiality.

Care records provided accurate guidance for staff to enable them to support people safely and effectively and were regularly reviewed.

The service had received many compliments and no complaints although people knew how to raise concerns if they so wished.

The registered manager had a clear vision and direction for the service and was assisted by an effective management team with a supportive registered provider.

Quality assurance procedures were under regular review to ensure they provided the necessary information to evaluate the effectiveness of the service and highlight any areas for improvement. The processes in place showed the service was operating in a positive manner meeting people’s needs as they wished them to be met.