- Homecare service
Top4Care Services Ltd
Assessment report published 7 September 2026
Contents
Ratings
Our view of the service
We carried out this assessment from 2 to 6 July 2026. Top4Care Services provide supported living services to people, including those living with learning disabilities, mental health conditions and sensory impairments. At the time of the assessment, 7 people were using the service and receiving personal care.
We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence, and good access to community facilities.
The service is also registered as a domiciliary care service, although at the time of our assessment there was no one receiving a regulated activity. We therefore did not assess this part of their registration.
During the assessment, we identified breaches of regulation relating to governance. We discussed the concerns with the management team during the assessment to enable them to begin taking action. The provider responded positively, and following the assessment took prompt action to address the concerns identified.
Governance systems were not always robust and did not provide leaders with effective oversight of the service. As a result, leaders had not identified or addressed a range of concerns, including medicines management issues, gaps in competency oversight, the absence of key policies and procedures, and shortfalls in care planning. Medicines were not always stored safely, and medicines audits had not been completed. This meant the provider was unable to identify concerns, including gaps in staff competencies.
The provider had not ensured key policies and procedures were in place, such as the use of CCTV or how to support people if they wished to change provider.
Whilst people received care that met their needs, care plans did not always provide clear guidance to staff on how to support specific health conditions. We also found people were not consistently supported to consider and record their wishes for future care, including end-of-life preferences.
Whilst governance systems were not always effective, we also identified areas of good practice. Staff received training to support them to carry out their roles safely. Systems were in place to manage safety, including incident reporting. Leaders promoted an open culture and incidents, complaints and concerns were recorded and used to inform learning.
People's experience of this service
We received positive feedback from people and relatives about their experience using the service. People and relatives felt staff were well trained and knew them well.
We used the Short Observational Framework for Inspection (SOFI), to understand the experiences of people who were less able to communicate verbally. Staff treated people with kindness and compassion. They were familiar with people’s routines, and we saw that staff offered people choices.
Leaders were visible within the service and worked with people to develop person-centred care plans. They focused on supporting people to meet their needs and preferences, alongside working with other professionals to ensure continuity of care.
People were supported to maintain healthy lifestyles that met their individual preferences. People were involved in discussions about their care and support. Following incidents, staff reviewed with people what had happened and discussed changes that may prevent similar incidents from occurring.
People were supported to access healthcare services and their community to maintain their independence. People benefitted from positive relationships with staff and leaders, who were committed to supporting their wellbeing and independence.
Leaders maintained regular contact with people and were approachable. Relatives told us communication with the service was good and they were informed about changes in people’s health and wellbeing.
While people and relatives expressed general satisfaction with their care and treatment, our assessment identified areas where care and support did not always meet expected standards.