Courage Healthcare Ltd

Updated 4 March 2026

We completed this inspection on 9 March 2026. Courage Healthcare Ltd is a domiciliary care service providing the regulated activity of personal care to people in their own homes and within a supported living service. At the time of the inspection, Courage Healthcare Ltd was supporting 2 people with the regulated activity of personal care.

We found 4 breaches of legal regulations in relation to consent, safe care and treatment, person centred care and good governance.

People told us they felt safe and supported by staff who knew them well and treated them with kindness, respect and compassion. Staff understood people’s individual routines, communication needs and preferences, and worked in a consistent way to reduce anxiety and promote independence. People were involved in everyday decisions about their lives. Support with diet, activities and wellbeing helped people to live healthier lives.

However, we identified concerns relating to safety, governance and oversight. Risks were not always well assessed or clearly documented and some care plans and risk assessments lacked sufficient detail to guide staff and external professionals. Systems for reporting, reviewing and learning from incidents had recently been introduced but were not yet embedded and leaders did not always have effective oversight to identify patterns or trends. Records relating to capacity, consent, restrictions and best interest decisions were inconsistent and did not always fully reflect requirements of the Mental Capacity Act.

Staffing arrangements were not always effectively monitored with some staff working extended hours without adequate rest, increasing the risk of fatigue to staff and harm to people they cared for. Although staff had completed mandatory training and understood safeguarding processes, supervision, appraisal and quality assurance systems were weak and relied heavily on self-assessment, limiting opportunities for robust challenge and continuous improvement.

Leaders were visible and approachable and described a clear vision for improving the service. They had begun to engage with external organisations and professionals to strengthen practice and governance.

We have asked the provider for an action plan in response to the concerns found at this assessment.

Updated 4 March 2026

People generally had a positive experience of the service. People appeared settled and comfortable, and a healthcare professional told us that interactions between people and staff were warm, familiar and respectful.

People were supported by staff who knew them well and understood their individual needs, routines and communication methods. Many staff had worked with people for a long time, which helped promote consistency and trust. A healthcare professional told us, “Staff treat people as individuals and really understand how to support them.” A healthcare professional told us they observed staff to be kind, patient and attentive, particularly when supporting people who could become very distressed.

People were encouraged to make choices in their day‑to‑day lives. Staff offered choice around food, clothing, activities and daily routines, and supported people to be as independent as possible. People took part in activities that reflected their interests, including community outings, car journeys, spending time with animals and shared leisure activities at home. One member of staff told us, “It’s about what matters to them, not just sticking to a routine.”

People’s privacy and dignity were respected. Staff explained what they were doing when providing personal care and ensured people’s privacy was maintained. People were supported with reassurance and calm communication when they became anxious or distressed.

However, people’s views were not always clearly captured in written records. Care plans were not consistently accessible for people or clear in showing how people had been involved in decisions about their care. This meant people‑centred care was evident in practice but not always fully reflected in documentation. People’s complex decision making did not follow the Mental Capacity Act (2025).