The Care Quality Commission
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Archived: First Class Care

Overall: Requires improvement read more about inspection ratings

83/85 Derby Road, Nottingham, Nottinghamshire, NG1 5BB (0115) 924 3111

Provided and run by:
First Class Care Limited

Important: This service is now registered at a different address - see new profile

All Inspections

28 July 2016

During an inspection looking at part of the service

This inspection took place on 28 July 2016. First Class Care is a domiciliary care service which provides personal care and support to people in their own home across Nottinghamshire and 11 people were using the service. At the time of our inspection First Class Care was operating from an address which was not registered. The provider had not taken the appropriate action to correctly register the location.

The service had not had a registered manager for 15 months prior to our inspection. 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. A new manager had been recruited and was due to start working at the service shortly after our inspection. We will monitor the situation to ensure that an application to register is made.

We carried out an announced comprehensive inspection of this service on 31 March & 1 April 2016. Breaches of legal requirements were found in respect of recruitment procedures and good governance. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for (location's name) on our website at www.cqc.org.uk

Improvements had been made to the recruitment procedures. Staff were required to undergo an interview and assessment process prior to being offered work. Appropriate checks of their conduct in previous employment, identification and criminal record were carried out. These checks are important to assist providers in making safer recruitment decisions.

Improvements had also been made to the systems used to assess and monitor the quality of the service provided. People were regularly asked for their opinion and changes made to their care package where necessary. Audits were carried out on staff performance and record keeping and any issues identified were acted upon. Improvements had been made to record keeping although there were still occasions where staff had not fully completed records relating to the care they had provided to people.

31 March 2016

During a routine inspection

This inspection took place on 31 March and 1 April 2016. First Class Care is a domiciliary care service which provides personal care and support to people in their own home across Nottinghamshire and 14 people were using the service. At the time of our inspection First Class Care was operating from an address which was not registered however the provider had submitted the relevant applications to rectify this.

The service had not had a registered manager for eleven months prior to our inspection although an application had been made. 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.

At our inspection in October 2015 we asked the provider to take action to make improvements in respect of recruitment procedures, staffing levels, safeguarding people from the risk of harm and the management of medicines. During this inspection we found that sufficient improvements had not been made in respect of recruitment procedures. The provider had not carried out all of the required pre-employment checks to assure themselves that staff were suitable to work with vulnerable adults.

This was a breach of Regulation 19 and you can see what action we told the provider to take at the back of the full version of the report.

There were sufficient staff available to meet people’s needs and they were effectively deployed. People felt safe and staff had a good understanding of how to safeguard people from the risk of abuse. Risks to people’s health and safety had been assessed and steps taken to reduce the risks. People received their medicines as prescribed and staff had been provided with training in managing medicines.

At our inspection in October 2015 we asked the provider to take action to make improvements in respect of supporting staff, the use and application of the Mental Capacity Act (2005), supporting people to eat and drink and taking action when they were concerned about people’s health. During this inspection we found that sufficient improvements had not been made in respect of staff training. Staff had received some training since our previous inspection but further training was still required. Staff told us they felt well supported by the manager and provider.

People received the support they required to have enough to eat and drink and staff reported any concerns about their health.

The Care Quality Commission (CQC) monitors the use of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). People had the capacity to make their own decisions and their consent was sought before care was delivered. There was a process in place to support people who may lack the capacity to make a decision.

People were cared for by staff who had developed caring relationships with them. People and their relatives were able to be involved in planning their care and making decisions. Staff treated people with dignity and respect and respected their right to privacy.

At our inspection in October 2015 we asked the provider to take action to make improvements in respect of providing person-centred care. During this inspection we found that sufficient improvements had been made and people received the care they required and staff punctuality had improved. Care plans were reviewed and updated when required. Any complaints received were investigated and responded to in a timely manner.

At our inspection in October 2015 we asked the provider to take action to make improvements in respect of their quality assurance processes and record keeping. During this inspection we found that sufficient improvements had not been made in all areas. The systems to assess and monitor the quality of the service were not operated effectively. Records relating to people’s care and staff support were not always accurate or up to date.

This was a breach of Regulation 17 and you can see what action we told the provider to take at the back of the full version of the report.

People were asked for their opinions on how the service was run and told us they felt comfortable speaking with the provider or manager. There was an open and transparent culture within First Class Care and staff told us they would feel comfortable speaking up and reporting any mistakes.

16 October 2015

During a routine inspection

This inspection took place on 16 October 2015. First Class Care is a domiciliary care service which provides personal care and support to people in their own home across Nottinghamshire. On the day of our inspection 11 people were using the service. At the time of our inspection First Class Care was operating from an address which was not registered. The provider had not taken the appropriate action to correctly register the location.

The service had not had a registered manager for five months prior to our inspection. The nominated individual had applied to become the registered manager and we have referred to them as ‘the manager’ in this report. 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.

At our inspection in May 2013 we asked the provider to take action to make improvements in respect of recruitment procedures. During this inspection we found that sufficient improvements had not been made. The provider had not carried out all of the required pre-employment checks to assure themselves that staff were suitable to work with vulnerable adults.

There were not enough staff available to meet people’s needs in a timely manner. Not all of the necessary steps had been taken to safeguard people from the risk of abuse. Risks to people’s health and safety had not been appropriately assessed or managed. People did not always receive their medicines as prescribed and staff had not been provided with accredited training in managing medicines.

Staff had not been provided with the knowledge and skills to care for people effectively. There was no formal supervision process in place for staff. People did not always receive the support they required to have enough to eat and drink.

The Care Quality Commission (CQC) monitors the use of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). There was a lack of knowledge of the MCA and the rights of people who may lack the capacity to make decisions were not upheld. Where people had the capacity they were asked to provide their consent to the care being provided.

People and their relatives were able to be involved in planning their care, however their choices were not always respected. Excessive delays in care being provided meant people’s dignity could be compromised. However, people were treated in a respectful manner by staff. People were cared for by staff who had developed caring relationships with them.

People did not always receive the care they required at the agreed time because staff were often early or late. People’s care plans had never been reviewed so we could not be sure that staff were providing the care that people needed. Whilst the complaints we saw had been appropriately responded to, we could not be sure that the provider had received all complaints.

At our inspection in May 2013 we asked the provider to take action to make improvements in respect of record keeping. During this inspection we found that sufficient improvements had not been made. Staff did not always complete records accurately and some entries were blank. Records were not securely stored.

People had not been asked for their opinions on how the service was run. There were no systems in place to evaluate and improve the quality of the service. The service did not have effective management and records were not always accurate or stored securely.

We found a number of 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 back of the full report.

The overall rating for this service is ‘Inadequate’ and the service is therefore in 'Special measures'. The service will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

22 May 2013

During a routine inspection

People expressed their views and were involved in making decisions about their care and treatment. We spoke with two people who were using the service who spoke positively about the way in which they were treated by staff. One person said, 'The staff are so nice, they know me now and I look forward to their visits.' We were also told, 'The staff are very nice, I wouldn't stand for it if they weren't.'

We looked at the care plans of four people who were using the service. A care plan should describe a person's needs and give guidance to staff about how to meet those needs. These provided adequate information to staff and were written in a person centred way. The staff we spoke with displayed a good understanding of people's needs.

The staff we spoke with understood their role in safeguarding vulnerable adults. Staff had received training in safeguarding as part of their induction and told us that further training was to be provided. Appropriate pre employment checks had not always been carried out before a staff member started working.

People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. People were not fully protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not always maintained.