Archived: Satellite Consortium Limited

Updated 18 August 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 4 October 2017 and was announced. We gave the service 48 hours’ notice of the inspection as this is a domiciliary care agency and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

The inspection was carried out by two inspectors and two experts by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. They did not return the PIR and we took this into account when we made the judgements in this report. We reviewed information we held about the service, including previous reports and notifications sent to us at the Care Quality Commission (CQC). A notification is information about important events which the service is required to send us by law. We contacted the local authority about their views of the quality of care delivered by the service.

During our visit to the office we spoke with the manager, one field supervisor, one administrator and one finance officer. We looked at 13 people’s care records and nine staff personnel files including recruitment, training and supervision records, and staff duty rosters. We also reviewed records relating to the management of the service including safeguarding, complaints records, and observation visits. Following the inspection we spoke to 18 people using the service, five relatives, and four care staff. We phoned people using the service and their relatives to ask them their views on service quality.

We reviewed the documents that were provided by the manager (on our request) after the inspection. These included an improvement action plan, training matrix, policies and procedures and care records for three people.

Updated 18 August 2018

This was an announced comprehensive inspection that took place on 4 October 2017. Satellite Consortium Limited is a domiciliary care service registered to provide personal care to people in their own homes. The service provides care and support for older people, people with physical and learning disabilities and sensory impairment and people living with dementia. At the time of inspection, the service was providing personal care to 68 people.

This service was last inspected on 28 September and 27 October 2016 where it was rated Requires Improvement. At the last inspection we found the provider to be in breach of four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations relating to mental capacity assessments, risk medicines administration, staff training, staff supervision and governance. After that inspection, the provider sent us an action plan to say what they would do to meet legal requirements in relation to the breaches.

At this inspection we found that the provider had not fully followed their plan, which they had told us would be completed by February 2017. The provider had not addressed the breaches of the abovementioned regulations and there were repeated breaches in relation to the need for consent, safe care and treatment, staffing and good governance.

The service did not have a registered manager in post. The provider had appointed a new manager who was undergoing the registration process with the Care Quality Commission. 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.

The provider did not identify, assess and mitigate risks associated with people’s health, care and mobility needs. Staff were not provided with sufficient information around risks involved in supporting people and how to minimise those risks to provide safe care. The associated care plans were not individualised and regularly reviewed. Staff were not provided with comprehensive and up-to-date information about people’s needs or how to support people safely whilst meeting their individual health and care needs. The provider did not maintain appropriate medicines administration records (MARs) for people who were supported with medicines administration and prompting. People’s care plans did not make reference to their mental capacity to make their own decisions. The provider did not effectively monitor staff punctuality and timekeeping, and missed and late visits were not recorded.

The provider did not notify us of two safeguarding cases. Not all staff received safeguarding training and staff lacked understanding of how to identify and report abuse. Safeguarding records did not give details on the investigation outcomes.

The provider did not follow safe and appropriate staff recruitment practices. Some staff recruitment checks including criminal record and reference checks were not in line with the provider’s policy.

Staff were not provided with induction training before they started working with people. Staff did not receive regular supervision, yearly appraisals and refresher training to enable them to do their jobs effectively.

People were encouraged to raise concerns and complaints. Staff told us they investigated people’s complaints but these were not recorded and there were no records of the investigation outcomes and lessons learned.

The provider did not maintain effective data management and monitoring systems to assess the quality and safety of care delivery. The provider was not auditing systems and processes related to care that was being provided including daily care logs and MARs. The provider had not analysed the feedback from people’s annual survey and had not identified areas of improvement.

People and their relatives told us staff were caring and helpful and treated them with dignity and respect. Staff were not trained in equality and diversity and dignity in care. People told us they generally received care from the same team of staff. People were happy with nutrition and hydration support.

We found the registered provider was not meeting legal requirements and there were seven breaches of the Health and Social Care Act 2008 (Regulated Activities regulations. These were in relation to the need for consent, safe care and treatment, safeguarding service users from abuse, acting on complaints, staff training and supervision, fit and proper persons employed, and for systems and processes to improve the quality and safety of the services including maintaining accurate records. We also found one breach of regulation 18 (Registration Regulations 2009) in relation to the notifications of other incidents.

Full information about CQC’s regulatory response to any concerns found during inspections is added to the back of the full version of the reports after any representations and appeals have been concluded.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. Services in special measures 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 signification improvements within the timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.”