Standard Care Limited

Standard Care is a domiciliary care agency. It provides personal care to people living in their own homes. The service provides personal care to older people, some of whom have dementia. At the time of our inspection there were 75 people 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

People and their relatives gave good feedback about the support they received from care staff who helped to keep them safe.

Risks to people’s care were not always appropriately managed. The provider was in the process of updating people’s care records. Where people’s records had been updated, we found risk assessments had identified risks and included clear risk management guidelines to assist staff. Where care records had not been updated, we found risk assessments were lacking in clear instructions for staff on how to manage identified risks.

People were safeguarded from the risk of abuse and avoidable harm. The provider had systems in place to manage allegations of abuse. Care staff had received training in how to identify and manage concerns relating to abuse and they demonstrated a good understanding of their responsibilities.

People’s care was monitored to ensure it was delivered on time and there were no missed care calls. The provider used an electronic system to monitor care calls, which was constantly reviewed. Where concerns were identified, these were followed up immediately.

Staff felt supported working for the provider and enjoyed working at the service. They confirmed they had received an appropriate induction, training and ongoing support.

The provider had effective monitoring and auditing systems in place to identify issues with the quality of the service. The provider had identified concerns relating to their risk assessments and were in the process of updating these.

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 requires improvement (published 14 May 2019) and there were multiple breaches of regulation at this inspection. The provider completed an action plan following this inspection to show what they would do and by when to improve. We re-inspected the service on 1 October 2020 and found improvements had been made, but we were unable to change the rating.

Why we inspected

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

Enforcement and recommendations

We have found a breach in relation to risk management. Please see the action we have told the provider to take at the end of the full version 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.

Standard Care Limited is a domiciliary care agency providing personal care to people living in their own homes. At the time of the inspection, the service was supporting approximately 60 older adults living in the boroughs of Westminster, Hammersmith and Fulham and Kensington and Chelsea.

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

Risks to people safety were assessed and managed appropriately. The provider had clear systems in place to manage infection control risks. There was enough Personal Protective Equipment (PPE) available and staff had received up to date training.

People’s medicines were managed safely and the provider had clear safeguarding policies and procedures in operation.

The provider conducted comprehensive assessments of people’s care and had clear plans of people’s care in place.

The provider supported people with their nutritional needs and took appropriate action when their healthcare needs changed.

The provider acted in line with their duty of candour obligations and had adequate auditing systems in place to monitor the quality of the service. The provider was operating an electronic monitoring system to ensure care was provided to people as and when needed.

Rating at last inspection and update

The last rating for this service was requires improvement (published 14 May 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in response to concerns received about staffing levels, safeguarding concerns and infection control risks. A decision was made for us to inspect and examine those risks.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

We found no evidence during this inspection that people were at risk of harm from these concerns.

Please see the safe, effective and well- led sections of this full report.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Why we inspected:

This was a planned inspection based on our routine scheduling programme.

People's experience of using this service:

¿ People were supported by kind and caring staff.

¿ People using the service told us they felt safe and trusted staff members providing care and support.

¿ People's needs were recorded in support plans. However, support plans did not always provide sufficient detail about people’s medical histories and current health status.

¿ Risk assessments were in place. However, these were often generic and did not always consider the specific needs of each person using the service.

¿ People were reminded to take their prescribed medicines. However, the recording of this task did not provide sufficient information as to whether people had actually been observed taking their medicines and medicines administration records (MAR) were not in use within the service.

¿ Quality assurance systems required further development to ensure the service provided to people was consistently safe and effective.

¿ People were supported to eat and drink enough where this formed part of an agreed care package.

¿ Systems in place to track and monitor all visits to people’s homes were currently ineffective.

¿ Staff records contained relevant documentation to demonstrate appropriate checks had been undertaken prior to new staff members commencing employment.

¿ Staff completed an induction period that included shadowing more experienced members of staff before working with people on their own.

¿ Staff understood the provider’s safeguarding policies and were familiar with reporting procedures including whistleblowing.

¿ Staff told us they were well supported by the management team and received training relevant to their roles and responsibilities.

¿ The service was working in partnership with other agencies, services and providers.

¿ When incidents had taken place or complaints had been received, the registered manager acted on these and investigated what had taken place.

Rating at last inspection: At the last inspection the service was rated Requires Improvement. (Report published 28 April 2018).

Why we inspected:

This was a planned inspection based on our routine scheduling programme.

Enforcement: We found breaches of the regulations in relation to safe care and treatment and good governance. Please see the ‘action we have told the provider to take’ section towards the end of the report. We also made a recommendation about medicines management systems.

Follow up: We will speak with the provider following the publication of this report to discuss how they will make changes to ensure the rating of the service is increased to at least Good. We will continue to monitor intelligence we receive about this service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

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

This service is a domiciliary care agency. It provides personal care for people living in their own houses and flats in the community. It provides a service to older adults. At the time of the inspection they were supporting 40 people using the service in the London Boroughs of Hammersmith, Fulham, Kensington and Chelsea. Not everyone using Standard Care receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

There was a registered manager at the service. 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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People’s care records did not always contain enough information about their medical histories. People were supported with their nutritional needs where this formed part of their package of care.

The provider’s quality assurance systems supported the delivery of good care. However, the registered manager had not identified the issues we found in relation to people’s care records. She assured us she would rectify these issues as soon as possible.

Staff demonstrated knowledge of their responsibilities under the Mental Capacity Act 2005 (MCA). Care records were signed by people using the service to demonstrate that they consented to their care.

People and their relatives gave positive feedback about care workers. Care workers were passionate about promoting people’s independence and ensured people's privacy and dignity was respected and promoted.

Risk assessments and support plans contained a sufficient level of information about how care workers were expected to mitigate known risks.

Care staff understood people’s personal preferences and had a good understanding of their life histories. Care records included information about people’s hobbies and pastimes.

Safeguarding adults from abuse procedures were in place and care workers understood how to safeguard people they supported. Care workers had received safeguarding adults training and were able to explain the possible signs of abuse as well as the correct procedure to follow if they had concerns.

People we spoke with and their relatives told us they were involved in decisions about their care and how their needs were met.

Recruitment procedures were thorough and ensured that only staff who were suitable worked within the service. The service also ensured there were sufficient numbers of suitable staff to support people.

The provider had an appropriate complaints procedure in place. Complaints were investigated and responded to in a timely manner.

Staff had the skills, knowledge and experience to deliver effective care and support, and received support for their roles. There was an induction programme for new staff which prepared them for their role.

The provider had a clear vision to deliver high-quality care and support. Staff demonstrated that they were clear about the values of the organisation and said these guided their work.