Codeko Homes - Berkshire

Updated 21 December 2022

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 and is registered to provide personal care to people living in their own houses or flats. This service also provides care and support to people living in a ‘supported living’ setting, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

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 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 a registered manager in post and supported us during inspection.

Notice of inspection

We gave the service 48 hours’ notice of the inspection to be sure that the registered manager would be in the office to support the inspection. We visited the location’s office on 6 October 2022.

What we did before the inspection

Prior to the inspection we looked at all the information we had collected about the service including notifications the provider had sent us. A notification is information about important events which the service is required to tell us about by law. We used this information to plan our inspection. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. The PIR request are sent on the anniversary date of the first inspection therefore this would be done at a later date for this service.

During the inspection

We spoke with the registered manager and one of the service managers. We reviewed a range of records including people's care and support records and other associated records. We also looked at a variety of records relating to the management of the service, including recruitment information, quality assurance, medicine records and some policies and procedures. We met the person using the service and observed how staff interacted with them.

After the inspection

We contacted nine staff and spoke to four staff team members. We looked at further information such as training data, recruitment, incidents/accidents, further records of care and support, policies and other service management records sent to us after the inspection. We contacted relatives and received three responses. We sought feedback from the local authority and professionals who work with the service and received five responses.

Updated 21 December 2022

About the service

Codeko Homes – Berkshire is a service providing personal care to people in their own homes. This service provides care and support to people living in a number of 'supported living' settings, so that they can live as independently as possible. The service provides support to people with mental health and learning disabilities or autistic spectrum disorder, and younger adults. Not everyone who used the service received 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. At the time of our inspection there was one person using the service while receiving regulated activity of personal care.

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

The provider did not always operate effective quality assurance systems to oversee the service. These systems did not always ensure compliance with the fundamental standards and identify when the fundamental standards were not met. The provider did not always use effective recruitment processes in place to ensure that the person was protected from staff being employed who were not suitable. The management of medicines was not always safe. The registered manager did not always inform us about notifiable incidents in a timely manner.

We have made a recommendation about seeking guidance from a reputable source to ensure the principles of the Accessible Information Standard were met.

The management team and staff carried out risk assessments and had drawn up care plans to ensure person's safety and wellbeing. We noted some parts of risk assessment could have more specific information recorded to ensure all support records were clear and consistent.

We have made a recommendation about keep records in regard to risk assessment and risk management strategies.

We judged people were supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible and in their best interests. However, the policies and systems in the service had to be improved to continue supporting this practice.

The person, their families, professionals and others that mattered were involved in the planning of their care and kept in touch with the provider. Staff understood their responsibilities to raise concerns and report incidents or allegations of abuse. The staff team followed procedures and practices to control the spread of infection using personal protective equipment. Staff understood how to treat the person with care, respect, and kindness. Staff upheld person's privacy and responded in a way that maintained their dignity. Staff said the staffing levels were sufficient to do their job safely and effectively. When incidents or accidents happened, it was recorded and reviewed by the registered manager to ensure it was fully investigated, lessons learned and shared with the staff team.

Staff received training to ensure they had the knowledge and skills to support the person. The provider had been changing their system for monitoring staff training was up to date. The management team appreciated staff contributions and efforts to ensure the person received the care and support they needed. Staff communicated and worked well together. They felt they could approach the management team at any time. Staff had support via supervision and appraisals sessions. The management team was working with the local authority and different professionals to investigate safeguarding cases and other matters relating to person’s health and wellbeing. There was an emergency plan in place to respond to unexpected events. There was a process to manage complaints effectively and according to the provider's policy. Staff deployment and management of shifts ensured the person received their care as planned.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was first registered with us on 26 April 2019. The service has not been providing regulated activity of personal care meaning the service has been dormant until 29 March 2021. This is the first inspection of the service.

Why we inspected

The service has never been inspected. This inspection was prompted by a review of the information we held about this service.

Enforcement and Recommendations

We have identified breaches in relation to quality assurance, notification of incidents, management of medicine, and recruitment. We have made a recommendation about meeting the Accessible Information Standard and keeping records for risk management strategies. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.