VIP Homecare

VIP Homecare is a domiciliary care agency providing personal care to people living in their own homes. At the time of the inspection 18 people were receiving personal care. 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.

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

At our last inspection we found risk assessments were not in place for people’s identified risks and auditing systems did not ensure improvements were identified and actioned. At this inspection we found improvements had been made, however, we found risk assessments were still not in place for all identified risks. The provider had started to update their auditing systems; however, they were still not robust enough to ensure shortfalls were identified to make improvements.

At our last inspection we found the provider had failed to ensure people were protected from the risk of abuse. The provider had made improvements to their systems in place and people were now protected from the risk of abuse.

People were supported to have maximum choice and control of their lives. People were supported by enough staff who were safely recruited to work in the service. People’s medicines were safely managed. The provider had effective systems in place to help protect people from the risk of infection. Staff informed us of the process they would follow if any incidents occurred.

The provider promoted a positive culture and staff showed an approach which helped achieve good outcomes for people. The registered manager understood their responsibility under the duty of candour and promoted an open and honest approach when something went wrong. People, their relatives and staff were involved in the running of the service. Staff confirmed they worked together as a team and with other professionals to support people.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 27 September 2022) and there were breaches of regulation. At this inspection we found the warning notice had only been partially met and there were still breaches of regulation.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. We undertook this focused inspection to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe and well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for VIP Homecare on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment and good governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

Following the inspection we had a meeting with the provider to discuss the concerns and action they will take. 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.

VIP Homecare is a domiciliary care agency. It provides personal care to people living in their own homes. At the time of the inspection 28 people were using the service. 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.

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

We found the risks to people’s health and safety had not been effectively assessed or managed. We received mixed views from people’s relatives regarding the provider’s ability to keep people safe. Some staff we spoke with lacked understanding of their safeguarding responsibilities.

Assessments of people’s needs were not always specific to the individual. The provider had not ensured all staff completed training appropriate to the care needs of the people they were supporting. The provider had failed to ensure people’s capacity to make particular decisions was always assessed.

People and their relatives gave positive feedback on the caring manner in which staff delivered their care. The provider ensured people’s views were sought on a regular basis. People and their relatives told us staff respected their privacy and dignity.

Care plans did not always provide clear guidance for staff to follow on how to meet people’s individual needs. The provider understood their responsibilities under the Accessible Information Standard. People and their relatives told us they felt listened to and were able to raise concerns with the provider knowing they would be resolved.

The provider had implemented systems to assess, monitor and improve the service. However, these systems had not led to the required improvements needed to provide high-quality care to people. People we spoke with told us they were actively engaged and communicated with.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

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 this service was good published (13 December 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for VIP Home care on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment, safeguarding and the provider’s governance systems.

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 meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The inspection took place on 13 December 2017 and was announced.

At the last inspection on the 12 and 15 December 2014, the service was rated Good; at this inspection we found the service remained Good.

People felt comfortable and safe in the company of staff who came into their homes and people were staff knew how to reduce risks to their safety when providing care. Staff were able to describe in detail the needs of people they supported and how to support people’s safety from potential abuse or neglect. Staff showed an awareness of the risks to people as these had been identified, assessed and were regularly reviewed. The registered manager shared learning from incidents and accidents to learn from these to assist in reducing the risks of similar occurrences from happening.

Environmental risks were assessed and any identified hazards to people who used the service and staff were reduced as far as possible. Staff were provided with the knowledge and equipment to reduce the risks of the spread of infections.

There were sufficient staff and people’s planned home care calls had been reliably completed. Efforts had been made to ensure wherever possible people were provided with care and support from staff they knew well in order to promote continuity of care for people. Background checks had been completed before new staff had been appointed to reduce the risks to people’s safety of being supported by unsuitable staff in their homes.

People benefited from having their specific needs met by staff who were supported and trained to ensure they had the skills to assist people effectively. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible. People were able to make decisions about how they wanted to receive support to ensure their health needs were met.

People who required assistance to eat and drink plans were in place to meet their individual needs and preferences. Staff linked in with healthcare professionals when people required support to maintain their health and wellbeing. People received assistance where required to take their medicines by staff who had been trained to do this and records were kept to reflect this was done safely.

People had built caring relationships with regular staff who provided their support. Care was planned and reviewed with people and the registered manager and their staff team ensured people's choices were followed. People's privacy, dignity and independence were respected and upheld by the staff who supported them. The registered manager had arrangements in place so confidential information was kept private.

People had care plans which included information about how they preferred to be supported. Changes in people’s needs were reviewed so they continued to receive care which was responsive to each person’s needs. People were confident to voice their complaints should they have any and these were investigated and responded to in line with the provider’s policy.

People’s views about the quality of their home care service were sought and their contribution supported the continual development of the services offered. The registered manager had a variety of quality checking and monitoring arrangements which supported them in identifying where improvements could be made. Staff and the registered manager had common values about keeping people at the centre of the care and support service they received in their own homes.

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Further information is in the detailed findings below.