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Focused Healthcare Limited Good

This service was previously registered at a different address - see old profile

Inspection Summary

Overall summary & rating


Updated 12 January 2019

This inspection took place on 8 November 2018 and was announced. Focused Healthcare Limited provides nursing and personal care for children and young people living in their own homes. This service is a domiciliary care agency. At the time of the inspection there were 80 people using the service.

There was a registered manager in post at the time of the inspection. The registered manager was not present during the inspection because they were on long term sickness leave. An interim manager was managing operational aspects of the service with support from the provider. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements the Health and Social Care Act 2008 and associated Regulations about how the service is run. Since our last inspection the service had changed to a new registered provider.

At our last inspection on 31 March 2016 we rated the service Good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

Risks for people were identified by staff. Risk management plans contained sufficient information for staff to manage and mitigate those risks. However, people’s daily records were not always completed as recommended. Staff followed the provider’s infection control policy to reduce the risk of infection.

Medicines were managed and administered safely. There were established systems in place for the administration, storage and disposal of medicines. We found the quality of the medicine administration records were not robust because staff did not always indicate when medicines were given to people. Staff completed training in medicines management and had their competency assessed.

There were established safeguarding systems and procedures in place. Staff understood how to protect people from harm and abuse. Safeguarding training was completed by all staff which helped them to take appropriate action to manage any allegations of abuse. These concerns were reported to a manager and to the local authority for investigation.

Enough staff were available and deployed to provide safe care to people. Safer recruitment processes were used to ensure suitable office based staff, nurses and care workers were employed at the service. Pre-employment checks were returned before staff were approved as suitable to work with people.

Relatives said staff were caring. Staff delivered care, support and treatment in a compassionate manner to ensure people received dignified care while maintaining their privacy.

Staff continued to receive an induction, training, supervision and appraisal. Staff were encouraged to explore and reflect on their jobs.

People were supported to have maximum choice and control of their lives and staff provided care in the least restrictive way possible for people. The provider’s policies and systems in the service supported this practice.

Staff asked people for their consent before providing care and treatment. People’s choices and wishes were recorded in health and care needs assessments. Care records were completed with and signed by people and their relatives. People were provided with copies of their assessments and care plan so they were aware of the support provided to them.

People had the care and support they needed that valued their levels of independence. This helped people continue their education and to take part in activities they enjoyed. Staff met people’s end of life needs when they required this specialist care and support.

Staff completed shopping for people when this was needed. Staff supported people with maintaining their nutritional needs which supported their health care condition and met their preferences.

The provider had a complaints p

Inspection areas


Requires improvement

Updated 12 January 2019

The service was not always safe.

Medicines were managed safely so people received them as prescribed. However, medicine administration records were not always accurate.

Staff assessed and identified risks for people and management plans guided staff to manage risks. However, people�s daily checklists and charts were not always completed to confirm essential checks of equipment had taken place.

There were safeguarding processes that guided staff to protect people from the risk of harm and abuse.

Safe recruitment practices were used to employ suitable staff to work with people. Enough staff were available to support people safely.

Staff understood how to protect people from and reduce the risk of infection.



Updated 12 January 2019

The service was effective.

Staff received support through induction, training, supervision and appraisal.

The manager and staff understood the principles of the Mental Capacity Act 2005 (MCA).

People were supported to meet their nutritional needs.

People had access to health care services when their needs changed.



Updated 12 January 2019

The service was caring.

People and their relatives said staff were caring and kind.

Staff respected people and care and support was delivered in a dignified way.

People made decisions about their care and support that was coordinated in an effective way.



Updated 12 January 2019

The service was responsive.

Care and support was person-centred and staff supported people in the way they chose.

People were encouraged to attend activities they enjoyed.

Complaints were managed well and the complainant was responded to in a timely way.

People's end of life plans contained their wishes and opinions and these were respected and carried out accordingly.



Updated 12 January 2019

The service was well-led.

The registered manager was absent from the service at the time of the inspection. An interim manager was supporting the operation of the service with support from the provider.

Staff clearly understood their role within the service. Staff said they felt supported by the manager.

The service had quality assurance systems in place. Staff assessed, monitored, reviewed and improved the quality of service.

Staff developed working relationships with organisations which helped to co-ordinate care and support effectively.