Background to this inspection
Updated
9 November 2023
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 2 inspectors and an Expert 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.
Service and service type
Verrolyne Services Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.
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 not a registered manager in post. The service had a nominated individual who the provider had recruited to manage the service. The nominated individual had also applied to register as manager with the CQC and this was in progress at the time of our inspection.
Notice of inspection
The inspection was announced. We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure that the provider or members of the management team would be in the office to support the inspection. Inspection activity started on 13 September 2023 and ended on 06 October 2023. We visited the provider's office/service on 13 and 19 September 2023. We held a meeting with the nominated individual on 3 October 2023.
What we did before the inspection
We reviewed the information we already held about the service. This included the last inspection report and feedback from social care professionals and partners. We also reviewed notifications we had received. A notification is information about important events, which the provider is required to tell us about by law. 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. We used all of this information to plan our inspection.
During the inspection
We spoke with 2 care coordinators, 1 field care supervisor, 1 recruitment manager and 4 care staff. However, the nominated individual was unavailable during our inspection. We were supported by the care coordinators in the office. We arranged a meeting with the nominated individual at a later date as part of the inspection process to seek further clarification and assurance about the management of the service. We spoke with 2 people who used the service and 7 relatives for their feedback on the service. We also spoke with 3 social care professionals for their feedback.
We reviewed documents and records that related to people’s care and the management of the service. We reviewed 8 people's care plans, which included needs and risk assessments. We looked at other documents such as those for quality audits, staff training and recruitment. After the inspection we continued to seek clarification from the provider to validate evidence found.
Updated
9 November 2023
About the service
Verrolyne Services Limited is a domiciliary care agency located in the London Borough of Havering. It is registered to provide personal care to people in their own homes. It is registered to support adults aged 18 years and over, and children aged up to 17 years, all of whom may have mental health needs, learning disabilities, physical disabilities and sensory impairments. 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 the inspection, 53 people were using the service who received personal care.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
People’s experience of using this service and what we found
Right Support
Since our last inspection in April 2023, there had been a change in ownership of the provider which caused some disruption to the service. The service was not always safe because risks to people were not assessed and managed thoroughly. Systems and processes to protect people from the risk of abuse were in place but staff did not have up to date training in this area. We did not find evidence people had been harmed. However, there were concerns people were at risk of neglect because people experienced missed visits when the service failed to provide the care people had expected. Staff followed infection control procedures and people were protected from the risk of infections.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People and relatives told us staff were respectful and caring.
Right Care
Care to people was not always person-centred. Care plans and assessments of people’s needs lacked information for staff to meet people's needs safely. Not all staff had received up to date refresher training at the time of our inspection. There was a risk of staff shortages. People told us they had mixed experiences and feelings about staff punctuality and reliability. This was due to delays to their care and changes to their regular staff who attended their home. People’s dignity, privacy and human rights were respected.
Right Culture
Leaders and the culture they created did not always support the delivery of high-quality care. Quality assurance systems were not robust to identify some of the shortfalls in the service. People and relatives were contacted for their feedback about the service. The provider did not notify us of changes to the service in a timely way. The provider acknowledged that further work was needed to make improvements to the service. Staff told us they were supported by the new management team and received supervision to discuss their performance.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for the service was Good, (published on 23 May 2023).
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Verrolyne Services Limited on our website at www.cqc.org.uk
Why we inspected
The inspection was prompted in part due to concerns received following a change in ownership of the provider since our inspection in April 2023. We received concerns about staff recruitment, staff training, the coordination of care and the management of the service. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.
Enforcement and Recommendations
We have identified breaches in relation to safe care and treatment of people, staff training, safeguarding people from the risk of abuse and good governance at this inspection. We have made recommendations about how the service records staff support with people's medicines and completes initial assessments of people's needs.
Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
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.