Background to this inspection
Updated
3 December 2019
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 one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to older people living in their own houses and flats.
The service did have a manager registered with the Care Quality Commission. This means they 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
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 16 October 2019 and ended on 28 October 2019.
What we did before the inspection
We reviewed information we had received about the service since they registered with CQC. We sought feedback from the local authority.
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.
During the inspection
We spoke with the two people who used the service and four relatives about their experience of the care provided. We spoke with nine members of staff including the registered manager. We reviewed a range of records. This included care records and staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found and what actions they had taken in relation to feedback.
Updated
3 December 2019
About the service
Inspire (UK) Ltd is a domiciliary care agency providing personal care in people’s own homes. At the time of the inspection the service was providing care and support to 28 people.
People’s experience of using this service and what we found
People and their relatives were generally happy with the care and support they received. However, most people and their relatives told us call schedules were poorly managed, which sometimes lead to late or missed visits. Since the last inspection the provider had moved many of their record keeping and quality assurance systems to an electronic system. Due to poor integration of the new system, it was not always effective at monitoring the quality and safety of services provided and we found a number of record keeping gaps in people’s care files.
People told us they felt safe in the company of staff and practices which promoted safer recruitment decisions had improved. Staff were trained to administer people’s medicines and most people received their medicines as prescribed. People were supported by staff who were competent and skilled. Staff asked people for their consent before providing them with any care. People who used the service 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 consistently told us staff were kind and they mostly received support from the same core group of staff, which promoted good continuity of care. People’s care plans provided clear instructions for staff to follow on how to meet their needs. Staff provided personalised support and actively encouraged people’s independence whilst delivering care. However, information contained in people’s care plans did not always support staff with this practice, such as recording which tasks people could do for themselves and what they needed support with.
Most staff told us the registered manager was supportive and operated an 'open-door' policy. The registered manager and staff were keen to deliver a high-quality, person-centred service. During and after the inspection the registered showed they were committed to addressing our concerns.
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 16 October 2018) and there were two breaches of the regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made/sustained, and the provider was still in breach of one regulation. The service remains rated requires improvement. This service has been rated requires improvement for the last three inspections.
Why we inspected
This was a planned inspection based on the date of registration of the service.
Enforcement
We have identified breaches in relation to the systems of governance.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.