PI Care

Updated 29 March 2023

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 Health and Social Care Act 2008.

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 people living in their own houses, flats and specialist housing.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been in post for around 6 weeks and planned to apply to register with CQC.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to arrange to meet with the provider or managers to support the inspection.

Inspection activity started on 1 February 2023 and ended on 13 February 2023. We met with members of the management team in an agreed office space on 1 February 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. This included feedback from professionals who work with the service. We reviewed CQC notifications. These describe events that happen in the service that the provider is legally required to tell us about.

We used the information the provider sent us in the provider information return (PIR) which was completed before the last inspection. This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We used all this information to plan our inspection.

During the inspection

The people who received personal care from the service were not able to speak with us. We spoke with 4 relatives of people who received support from the service.

We spoke with 8 staff including the manager and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We received feedback from 7 professionals who were involved with people who received personal care from the service. We also received feedback from 5 professionals who had worked with people who did not receive a regulated activity from PI Care staff. We have not included their feedback about specific care because this is not in the remit of CQC, but we have considered their views about the provider more broadly because these related to the same staff and management team. Everyone’s comments have been incorporated into the report.

We looked at the records of the 3 people who received personal care. We also looked at 5 staff files in relation to recruitment and staff support, as well as audits, policies and procedures and quality assurance information.

We considered all of this information to help us to make a judgement about the service.

Updated 29 March 2023

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.

About the service

PI Care is a domiciliary care agency providing personal care and support to young people living in their own houses, flats and specialist housing. The service provides support to children and young people aged 4-18 years who have a learning disability, autistic people or people with mental health needs. It is also registered to provide support to adults who have a learning disability, autistic people or people with mental health needs.

At the time of our inspection, 3 people were receiving the regulated activity of 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:

Relatives told us their family members had choice and control and staff knew them as individuals, although some relative’s experience was less positive.

Staff supported people to make decisions where possible. Staff communicated with people in ways that met their needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff worked with families to meet people’s best interests. The policies and systems in the service supported this practice.

Staff received training about how to support people when they experienced periods of distress. People’s freedoms were restricted only if there was no alternative.

Staff worked with other organisations to ensure people received the care, support and treatment they required. We received a wide range of feedback from external stakeholders which is reflected in the report.

Staff supported people with their medicines to ensure their needs were met. Improvements had been made to ensure medicines were monitored and managed safely.

Right Care:

Concerns had been raised before the inspection about staff knowledge and experience to work effectively with people with complex needs. The provider had been supported to provide additional specialist training to ensure staff were skilled and delivered good quality support.

Concerns had been raised before the inspection that people were not always protected from the risk of harm and abuse. Professionals told us this had begun to improve recently. Policies and training were in place, and staff were clear about what could constitute abuse and what they should do to help keep a person safe.

Staff protected people and respected their privacy and dignity. Most relatives told us their family member’s preferences and views were respected. Some professionals felt staff needed additional training and skills to meet the complex needs of individuals using the service.

Staff told us they understood and responded to people’s individual needs. They were able to explain their role in respect of individual people and clearly knew them well. Staff we spoke to had a clear understanding of the risks faced by the people they supported.

Right Culture:

We received a very wide range of views about the organisation, standards, staff and managers. Terms used ranged from ‘awful’ to ‘amazing’. We have endeavoured to reflect this range and balance our judgement in the report.

The managers and staff we spoke to were committed to upholding the organisation’s values to support people effectively. There had been recent changes to the management structure to strengthen leadership and improve outcomes for people.

People’s families were involved in planning, service provision and reviews. They were encouraged to share their views and the management team were well known by families. The provider worked closely with a wide range of other organisations to improve people’s quality of life.

We received mixed feedback about the provider’s communication, although most professionals who commented noted that this had improved recently.

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 23 November 2022).

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We inspected this service due to an increase in concerns raised by professionals about the service. This included concerns about the knowledge and skills of staff, management oversight and the safety and wellbeing of the people being supported.

As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed to good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for PI Care on our website at www.cqc.org.uk.

Recommendations

We have made recommendations in relation to embedding robust governance and performance systems and continuing to develop quality assurance arrangements at this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.