4 August 2022
During a routine inspection
At the time of the inspection, the location did not support anyone with a learning disability or an autistic person. The registered manager told us they intended to remove this specialism from their registration as they did not intend to support people with a learning disability or autistic people at this time. However, we assessed the care provision under CQC’s Right Support, Right Care, Right Culture (RSRCRC) policy, as it is currently registered as a specialist service for this population group.
About the service
Homesaints Limited is a domiciliary care agency providing personal care to people living in their own homes. People had various support needs and health conditions such as, dementia, multiple sclerosis and diabetes. At the time of our inspection there were 22 people using the service in receipt of personal care.
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
Right Support:
People were supported by staff who were caring but people did not always have their choice for their preferred gender of staff respected. Systems did not always ensure that all aspects of risks to people had been assessed and measures put in place to reduce them.
The rota was not planned in ways that meant care visit times were carried out at times people expected them. This resulted in people believing staff to be late, which impacted on their wellbeing.
People were supported with their medicines where required. Staff also understood how to support people in ways that promoted their independence.
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 were supported by staff who understood them and what they liked and most care was personalised. However, there was some aspects of care that was not person centred and resulted in concerns about care visits, meals and risks.
Staff ensured information was in formats they could understand, such as verbally or in writing.
People told us staff were kind and caring and treated them with respect. Staff understood how to promote people’s dignity and privacy.
Right Culture:
People were supported by staff who had not received all of the appropriate checks on their suitability for the role. Staff had a good understanding of how to promote people’s rights to make choices as well as how to recognise or report abuse and safeguard people they were supporting.
The registered manager promoted person centred approaches but these were not always delivered as required. Checks on staff knowledge and skills were made to ensure they could meet people’s needs. The registered manager completed various audits of care and records, but these were not always effective at identifying concerns.
People were not always supported to identify clear goals to promote their independence and ensure care was personalised.
The provider did not ensure complaints and outcomes were recorded.
We have made a recommendation about ensuring people’s meals and drinks were clearly recorded and the provider review recruitment records and practices.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 12 May 2021 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to risk management, personalised care, records and quality assurance systems at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.