We carried out a review of the data available to us about QCM Healthcare on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about QCM Healthcare, you can give feedback on this 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.
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 for anyone with a learning disability or an autistic person, nor had they done so since being registered. However, we assessed the care provision under Right Support, Right Care, Right Culture, where possible, as it is registered as a specialist service for this population group.
People’s experience of using this service and what we found
People and their representatives told us there was a core of well-trained and skilled staff who knew them well and met their needs. The registered manager supported staff with less experience to develop their skills. However, systems were not in place to assess or review whether staff had gained the skills and knowledge to effectively care for people.
Care plans varied in quality and detail, in particular when support was arranged at short notice. In these instances, senior staff ensured information about peoples’ needs was shared verbally across the staff team. Although this mitigated the potential for risk, improvements were needed to ensure staff had personalised written guidance about all the people’s needs.
The registered manager had worked hard to address the concerns we had raised at the last inspection. They had implemented new systems to support senior staff sustain improvements as the service grew. Some of these systems still needed to be embedded into the service. However, the registered manager understood their service well and was committed to continuing to develop and improve quality of the service.
Recruitment and induction processes had improved, which supported the registered manager to provide safe care. There were enough staff to support people safely. The staff team were well supported, supervised and engaged.
Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it.
Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.
Staff worked well with people, their relatives and other professionals to maintain their health and wellbeing. Staff provided key support to people requiring end of life care, enabling them to continue to be cared for at home.
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.
Support was flexible and responsive. Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate.
Right Support:
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.
Right Care:
People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.
Right Culture:
People’s quality of life was enhanced by the service’s culture of improvement and openness.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
Rating at last inspection and update
The last rating for this service was requires improvement (published 14 December 2018) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. There was a delay in us returning to re-inspect as the service was dormant (not supporting people) from August 2019 until April 2022. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
QCM Healthcare is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older and younger people some of whom may have a physical disability. At the time of our inspection the service provided a regulated activity to 12 people.
There was a registered manager in post who was also the sole director. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
This was the first inspection of this service since registration with CQC on the 6 November 2017.
The provider did not have effective systems in place to ensure overall governance of the service and identify the issues we found at this inspection.
The provider did not have systems in place to ensure staff were sufficiently qualified, skilled and experienced to meet people's needs. There was a lack of planning and systems in place to provide staff with training relevant to their roles and responsibilities. Staff did not have access to regular, planned supervision to enable them opportunities to discuss their training and development needs. Robust recruitment checks had not taken place before staff started work, which put people at risk.
Risk assessments were in place to guide staff with steps they should take to reduce the risk of harm to people’s welfare and safety. For example, in relation to environmental risks, pressure area care and the risk of cross contamination. Staff followed good infection control procedures.
Accidents and incidents were recorded but there was no system of analysis to look for trends and plan for improvement. In the event of emergency there were plans to in place to ensure that care delivery was not impacted.
Arrangements were in place for people that required support with their medicines. However further work was needed to ensure medicines management audits were carried out to check people had received their medicines as prescribed.
There were enough staff employed to meet people's needs. People were supported by regular members of care staff, providing continuity of care to people.
People had been involved in the planning of their care and had developed good relationships with staff. People told us that they felt safe with all the staff that supported them. They said staff supported them with maintaining their independence and upheld their rights to choose how their care was delivered. However, staff had not been provided with training to understand their roles and responsibilities and how to apply the principles of the Mental Capacity Act 2005 (MCA) in their work. Where people had fluctuating capacity no best interest assessments had been carried out.
A full assessment of people's needs took place before people started using the service. People were supported to eat and drink, if this was part of their package of care and access to support from health care professionals when needed.
People understood how to make a complaint. There was a system in place to record and respond to complaints but none had been received since registration. There was no information to refer people if not satisfied to the complaints ombudsman and no contact information for the local authority who commissioned their care. The registered manager told us they would amend the information provided to people immediately.
Staff said they felt supported and valued. However, we found they had not been supported with all training needed, relevant to their roles and opportunities to have supervision and staff meetings.
During this inspection we identified breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the end of this report.