Simply Care Partners

Simply Care Partners Liability Partnership LLP is a domiciliary care agency that provides personal care to people living in their own houses and flats in the community. CQC only inspects the service being received by people provided with ‘personal care’, that is help with tasks related to personal hygiene and eating. Where they do this, we also take into account any wider social care provided. At the time of our inspection there was one person using the service.

People’s experience of using this service and what we found

The quality and safety of the service had improved for people since our last inspection. The provider had made changes to their recruitment and selection processes to reduce the risk of people being supported by unsuitable staff.

The provider had also reviewed and updated their medicines policy and procedures to make sure this reflected current best practice. This meant clear and accurate records were now being maintained in relation to people’s medicines. Our checks of the records of the person using the service indicated they received their medicines as prescribed.

The provider had improved their quality monitoring systems so that audits and checks now covered those areas of the service where we previously found gaps and shortfalls. This helped reduce the risk of the issues we found reoccurring.

The person using the service received support that had been planned and agreed with them. Their choices for how support was provided were respected and staff delivered this in line with their wishes. There were enough staff to meet the person’s needs. Staff knew the person well and understood their needs and how these should be met. Staff received relevant training and the provider made sure they were clear about their duties and responsibilities when providing care and support.

Staff were encouraged to treat the person with respect, maintain their dignity and privacy and to encourage their independence wherever possible, especially when being supported with their care needs. They made sure the person was able to do activities that interested them. The person was supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The person was supported to eat and drink enough to meet their needs. Records maintained by staff helped keep others involved in the person’s care, informed and up to date about the support provided to the person. Staff demonstrated a good understanding of the person’s healthcare needs and how they should be supported with these in a timely and appropriate way.

Staff were trained to safeguard people from abuse and to report any concerns they had to the appropriate person and agencies. Staff knew how to manage and minimise identified risks to the person’s safety and wellbeing. They followed good practice when providing personal care and when preparing and handling food which reduced hygiene risks.

The provider encouraged the person using the service and staff to have their say about how the service could improve. They had arrangements in place to make sure any events, incidents and complaints were investigated which included keeping people involved and informed of the outcome. Learning from investigations was shared with staff to help them improve the quality and safety of the support they provided.

Since our last inspection the provider had undertaken a review of the service and had made the decision to reduce the number of people they delivered care to. They had no immediate plans to take on new packages of personal care for people living in their own homes. However, if in the future they planned to take on new packages, they would make sure an appropriate staffing complement would be put in place to ensure care and support could be provided safely.

At the time of this inspection the provider and the local authority were working towards improving communication and information sharing between them . This should help to improve partnership working between the provider and the local authority so that any concerns about the quality and safety of the service would be dealt with in a more effective and appropriate way.

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 1 August 2018) and there was a breach of 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 we found improvements had been made and the provider was no longer in breach of regulation.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Simply Care Partners Liability Partnership LLP is a domiciliary care agency. It provides personal care to people living in their own home. At the time of our inspection twenty people were using the service. Not everyone using the service receives the regulated activity. CQC only inspects the service being received by people provided with ‘personal care’, that is help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

At this inspection we found some aspects of the service had deteriorated resulting in the overall rating for the service changing from ‘good’ to ‘requires improvement.’ The provider’s recruitment arrangements had not been robustly maintained. The provider had not queried discrepancies or sought additional assurances about the information provided by new staff in support of their applications to work. This meant the provider did not have all the assurances they needed about staff’s suitability to support people.

Staff supported people to take their prescribed medicines. Staff maintained written records each time medicines were administered. We noted this did not reflect current best practice issued by the National Institute for Clinical Excellence (NICE) to ensure a clear and accurate record was always maintained. The registered manager told us they would review their current medicines policy and procedure to ensure this reflected best practice.

The provider’s systems for assessing and monitoring the quality of the service had not been entirely effective. The issues we identified above around staff recruitment checks and compliance with current best practice in relation to medicines indicated a lack of management oversight of these aspects of the service which could have an impact on the quality and safety of the support people received. The registered manager said they would be taking immediate action after this inspection to rectify the issues we found. The provider wrote to us after the inspection to advise they had updated the written record staff were required to complete so that this reflected current best practice

Notwithstanding the issues above we found checks of other aspects of the service were regularly undertaken to review quality and safety in these areas. These included checks of people’s records, ‘medicines observations checks’ to review staff’s competency in this area and unannounced spot checks to people’s homes to observe staff’s general working practices when undertaking their duties. Where any gaps or shortfalls were identified through these checks prompt action was taken to remedy these including supporting and encouraging staff to learn from mistakes.

There were enough staff to meet people’s needs. People and their relatives were satisfied with the continuity, consistency and timeliness of support they received from staff during weekdays. However, they had mixed experiences about the support provided by staff at weekends. The provider was already aware of these concerns and had used their learning from people’s complaints to make required improvements. Feedback obtained by the provider from recent quality checks indicated that timeliness of visits appeared to have improved which was confirmed by a relative we spoke with. We will check at the next inspection of the service whether this improvement had been sustained and maintained.

People said they were safe when being supported by staff. Staff were well supported to take appropriate action to ensure people were protected if they suspected they were at risk of abuse. Staff had access to current information and guidance on how to minimise identified risks to people due to their specific needs. This helped to keep people safe from injury or harm.

People contributed to the planning of their care and support. Their care needs and specific preferences for how these should be met were set out in their personalised support plan. People said staff could meet their needs. Staff reflected the diversity of people using the service. This gave people more choice about who they received support from. Senior staff reviewed and updated people’s care and support plans as their needs changed to ensure staff had up to date information about the support people required.

Staff received regular and relevant training and were well supported by the provider to help them meet people's needs. They followed good practice to ensure risks to people were minimised from poor hygiene and cleanliness when providing personal care and when preparing and handling food.

People said staff were caring, considerate and provided them with support that was dignified, respectful and which maintained their privacy always. Staff supported people to be as independent as they could be.

People were supported to eat and drink sufficient amounts to meet their needs. Staff documented the support provided to people which kept others involved in people’s care up to date and informed. Staff monitored people’s general health and wellbeing and when they had concerns about this they took prompt action so that support could be sought from the relevant healthcare professionals.

People were satisfied with the care and support they received. The provider sought people’s and staff’s views about the quality of care and support provided and how this could be improved. People knew how to make a complaint if needed and the provider had appropriate arrangements in place to deal with these.

The service had a registered manager in post. People and staff spoke positively about the registered manager and said they were accessible and supportive. The registered manager understood their registration responsibilities particularly with regards to submission of statutory notifications about key events that occurred at the service.

The provider worked in partnership with other agencies to develop and improve the delivery of care to people. They worked collaboratively with local authorities funding people’s care so they were kept up to date and well informed about people’s care and support needs. This helped to ensure people continued to receive the appropriate care and support they required.

We checked whether the service was working within the principles of the Mental Capacity Act (MCA) 2005. The registered manger was trained in the MCA and were aware of their responsibilities in relation to the Act. Records showed people’s capacity to make decisions about aspects of their care was considered when planning their support.

At this inspection we found the provider in breach of legal requirements with regard to fit and proper persons employed. You can see what action we told the provider to take with regard this breach at the back of the full version of the report.

At the last inspection in December 2014, the service was rated Good.

At this inspection we found the service remained Good.

People said they were happy with the service provided and that staff helped them with the care and support they needed.

There were processes in place to help make sure people were protected from the risk of abuse and staff were aware of safeguarding vulnerable adult’s procedures and understood how to safeguard the people they supported. People’s individual risk was assessed to help keep them safe and staff had a good knowledge of this.

People and their relatives thought staff were caring and respectful. Staff knew the people they were supporting and provided a personalised service for them. Staff explained how they helped maintain people’s privacy and dignity.

The staff we spoke with told us they enjoyed their job and felt supported by the registered manager. Staff were up to date with training and the service followed appropriate recruitment practices.

People’s records were kept up to date and covered all aspects of the care and identified the support people needed so staff could meet their needs. Records were updated and regularly reviewed when people’s circumstances or healthcare needs changed.

People were asked about their food and drink choices and staff assisted them with their meals when required. People were supported to take their medicine when they needed it.

The manager regularly spoke with people to make sure they were happy with the service and carried out spot checks to review the quality of the care provided.