Provision Care Ltd

Provision Care Limited in Leicester, provides care and support for people in their own homes. The service was supporting 8 people at the time of the inspection. 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

There were systems in place to monitor incidents, accidents and safeguarding concerns and staff understood how to report these. Individualised risk assessments were in place, but they lacked detail to ensure safe care. The provider did not carry out safe pre-employment checks in line with organisational policy. Topical medications (creams) and ‘when required’ medicines were not managed safely, and the provider could not evidence staff had been assessed as competent to administer medications.

Support plans were in place but lacked detail on people’s needs. Staff were provided with training, but some training needs had not been identified. People were supported to make their own food and drink choices. There was evidence the provider worked collaboratively with external professionals, but feedback from professionals was mixed.

The provider responded to the views and wishes of people using the service, and feedback from relatives was positive. One relative said, “We’d like to say a big thank you, can’t praise them enough”. Staff told us they protect people’s dignity and they were knowledgeable about the people they support and how to promote independence.

The provider was responsive to people’s changing needs. However, complaints were not recorded, and the registered manager lacked knowledge on their responsibilities in this area. Support plans were found to be lacking information related to end of life care.

Management frequently visited people and delivered care. Staff told us management were approachable and supportive. There was a lack of robust and effective quality assurance processes in place to monitor the quality of the service. Organisational policies were not robust or tailored to the service and the training matrix was not fit for purpose.

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.

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 14 November 2017)

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches of regulation in relation to medicines, pre-employment checks, support planning and quality assurance systems at this inspection.

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 for the provider to understand what they will do to improve the standards of quality and safety. 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.

At the last inspection, in December 2015 the service was rated Good.

At this inspection we found the service remained Good.

The provider was also the registered manager for Provision Care Ltd. 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 continued to receive safe care. Staff recruitment processes were robust and ensured that people were protected from being cared for by unsuitable staff. There were enough staff to provide care and support to people to meet their needs safely. Staff were trained and understood their responsibilities to protect people from abuse and avoidable harm.

People continued to be protected from avoidable risks. A range of risks assessments were completed and preventative action was taken to reduce the risk of harm to people. Where people required support with their medicines, staff had been trained in the safe handling of medicine, which was supported by a policy and procedure. People were supported to maintain good health and nutrition.

People continued to receive effective care and support. Staff received an appropriate induction, ongoing training and support which ensured their knowledge and skills were kept up to date and they understood their role and responsibilities to work effectively.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People continued to receive good care. They had developed positive relationship with the staff who understood their needs. Staff were kind, caring and treated people with dignity and respect.

People continued to receive care and support that was responsive to their individual needs. Care plans were personalised and took account of people’s diverse, cultural and specific needs. This enabled staff to provide care and support in line with people’s wishes and preferences. Staff worked in a flexible way which promoted continuity of care so that they could meet people's needs in a person centred way.

People knew how to raise a concern or to make a complaint. The provider had a complaint policy and procedure and complaints received were investigated.

The service continued to be well managed. People and staff had confidence in the registered manager and found they were supported. The registered manager provided clear leadership, listened and acted on feedback. The registered manager was meeting their regulatory responsibilities and liaised with external agencies to ensure people received a safe service. Effective systems were in place to monitor and improve the quality of the service provided through a range of audits and views sought from people, their relatives and staff to influence the service and drive improvements.

Provision Care Ltd is a domiciliary care service providing care and support to people living in their own homes. The office is based in the city of Leicester and the service currently provides care and support to people living in Leicester. At the time of our inspection there were four people using the service and employed two staff.

Provision Care Ltd has a registered manager in post. 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 told us they felt safe with the care staff and the support they received. Care staff were confident to report any concerns about people’s safety, health or welfare to the registered manager or to the relevant external agencies.

People were involved in making decisions about their care and support needs and in the development of their care plan. Potential risk to people’s health had been assessed and measures in place were detailed in the care plans for care staff to refer to.

We found there were sufficient numbers of staff employed to meet the needs of people. Records showed that staff had undergone a robust recruitment process before they worked unsupervised with people who use care services.

People were prompted to take their medication where their plan of care had identified that the person required support. We found people’s medicines were managed well.

Staff had induction and on-going training that equipped them to support people safely. Staff were supported regularly through supervisions and staff meetings and checks were carried out on their practices.

People made decisions about their care needs and support needs. People’s plans of care reflected the support they required with regards to their personal care and where appropriate social support. Staff sought people’s consent before they were helped and promoted their independence and choices.

Staff supported some people with their meals and drinks in order that they maintained a balanced diet. People were supported with grocery shopping, meal preparation and cooking.

Staff supported people to liaise with health care professionals if there were any concerns about their health.

People told us that they were happy with the support they received. They had regular staff with whom they had developed a positive relationship with. People were complimentary about the care staff and found them to be kind and caring. People’s privacy and dignity was maintained, their choice of lifestyle was respected and their independence was promoted.

Staff were knowledgeable about the needs of people and took account of their preferences such as times, cultural and diverse needs. People received support from staff who were consistent, reliable and aware of their role to meet people’s care needs and promote their wellbeing and independence.

People told us they were aware of how to raise concerns. They were confident that any concerns raised would be responded to by the registered manager and the provider.

People who used the service and relatives told us that their views about the service were sought regularly. People told us that they were happy with how the service was managed.

The provider had a quality assurance system in place to assess and monitor the quality of service provided. Those included audits and checks carried out on the staff delivering care and review of people’s care.

The registered manager provided effective leadership and support to the staff in order to review and develop the service. The provider sought the views of people who used the service in a number of ways and used the information to make improvements and develop the service.