Background to this inspection
Updated
13 January 2021
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 Care Act 2014.
Inspection team
The inspection was carried out by two inspectors. One inspector visited the service on 09 December 2020 whilst a second inspector conducted phone calls to people’s relatives and staff on 11 and 14 December 2020.
Service and service type
This service provides care and support to people living in 22 supported living settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
The service does not currently have a registered manager. The previous registered manager had left the service in March 2020. A new manager had been managing the service since November 2020 and had submitted their application to become registered with us. Registered managers and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was announced. We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us. Inspection activity started on 09 December 2020, we visited the location to meet the people who used the service, the manager and staff; and to review care records and policies and procedures.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with three of the people who used the service about their experiences of the care provided. We spoke with four relatives by phone, seven staff members, the operations manager and care manager. We received written feedback from two external professionals. We reviewed four people's care records and three people's medication records. We looked at recruitment checks for three staff. We reviewed records that related to the management and quality monitoring of the service. This included accident, incident and safeguarding analysis, financial and staff supervision audits and fire safety checks.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at information about people's care needs, staff training and quality assurance.
Updated
13 January 2021
About the service
Precious Homes Birmingham provides personal care to people in their own flats within a supported living setting. The service provides personal care to younger adults who have a learning disability and or autistic spectrum disorders. At the time of the inspection there were seven people receiving personal care at 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
The provider had systems and processes in place to support the delivery of care and the safety of the service. However, these were not always used effectively to provide a consistent standard of care for people.
Potential risks to people’s safety were not always identified in relation to the safety of the environment. Infection control practices in relation to COVID-19, required improvement to ensure guidelines were understood and consistently followed to protect people and staff.
Staff understood how to safeguard people from harm and escalate concerns to relevant professionals. People and their relatives told us they felt safe at the service. More specific guidance for the use of, 'as required' medicines was needed to ensure people had these medicines safely.
Measures were in place to reduce the risk of infection during the COVID-19 pandemic. People’s safety was promoted through changes made to the layout of the premises to support social distancing.
Staff knew the risks to people’s safety and these were identified and managed. Relatives felt whilst people were safe and well cared for, consistency of good practice amongst staff, needed to improve. Accidents and incidents were analysed to identify causes, patterns or trends so that people’s support was identified to reduce such incidents.
There were enough care staff to meet people's needs. Maintaining safe staffing levels had been a challenge due to the COVID-19 pandemic, the provider had a contingency plan to determine safe minimum levels of staffing.
The provider had identified shortfalls and had a service improvement plan they were working to. They acknowledged there had been a period of inconsistent leadership which had impacted on the quality of people’s experiences. People, relatives and staff expressed confidence in the new manager. The manager confirmed that additional new senior posts were being created so that people and staff had the support they needed.
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 09 April 2019).
Why we inspected
We received concerns in relation to the management of people’s medicines, finances, infection control and staffing levels. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them.
Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Precious Homes Birmingham on our website at www.cqc.org.uk.
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.