Quantum Domiciliary Care Limited

Quantum Domiciliary Care Limited is a domiciliary care agency providing personal care to people living in their own homes. The service provides support to people living with dementia, older and younger adults, people with learning disabilities and autism and people with physical disabilities. At the time of our inspection there were 17 people using the service.

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

Recording of some aspects of care was not always clear and made monitoring of risks more difficult. Guidance for staff on how to apply creams was not clear for some people. An ‘as needed’ medicine for 1 person did not have any guidance for staff on why and when to use it. People were supported by safe numbers of staff and were mainly supported by the same staff group. People received support tailored to their individual needs. Relatives told us they were happy with the support their loved ones received.

Right Care

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. Staff knew people well and knew how they wanted to receive care. They understood what people could do for themselves and what they needed support with.

Right Culture

Some people’s care plans did not always include enough guidance for staff on how to support them with their care needs. Some care plans had not been updated with new guidance from other health professionals. Systems were in place to help staff monitor the quality of care plans, but they had not helped to identify the concerns we found. However, people were supported by the same staff who knew their care needs well and were aware of the updated guidance. The registered manager had not kept updated with national guidance. This meant staff had not received training to support people with learning disabilities and autism. This is now a legal requirement of the Health and Care Act 2022. We found no evidence that people had been harmed or were receiving inappropriate care as a result of this. People and their loved ones were involved in the planning and review of their care. Relatives told us they could get in touch easily with the management team and found them to be supportive. Staff told us they felt there was an open culture of learning in the team and the management were supportive. They spoke positively about the staff team and the managers.

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 and update

The last rating for this service was requires improvement (published 16 November 2019).

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 the provider remained in breach of regulations.

Why we inspected

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

Enforcement

We have identified breaches in relation to the quality assurance and governance systems in place at this inspection.

Please see the action we have told the provider to take at the end of this report.

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.

Quantum Domiciliary Care Limited is a domiciliary care agency providing personal care to 45 people at the time of 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

Systems around medicine management needed improving. Care plans and risk assessments were not in place for all of people's known risks. Where care needs had changed care plans and risk assessments had not always been updated to reflect people's most current needs. This placed people at risk of receiving unsafe care. People and their relatives told us they felt safe and safeguarding concerns had been referred to the appropriate body. People told us staff always turned up for calls but there was an issue with call times being inconsistent. Staff followed infection control guidance and had access to personal protective equipment.

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. Staff were knowledgeable about their role and told us they received sufficient training. The service contacted other professionals appropriately and in a timely manner.

People received care and support that respected their dignity and privacy. People were involved in their care plan reviews and were supported to make choices about their care. Where complaints had been received these were responded to in a timely manner.

Governance systems were either not in place or not robust. This meant that systems were not effective in monitoring the quality and safety of the service. People told us that the manager was approachable and

responsive and staff felt supported.

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 (10 October 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to Regulation 17, good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

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.

Quantum Care Limited is a domiciliary care service that provides support to people living in their own homes. Some people’s care was funded through the local authority and some people purchased their own care. At the time of our inspection 40 people received support from this service.

There was 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 were protected from the risk of abuse because staff received training so that they understood the different types of abuse and knew what actions were needed to keep people safe.

People felt safe and secure with staff coming into their homes because staff had the skills and knowledge to care and support them in their homes. There were sufficient numbers of staff available to meet people’s needs.

Before staff were employed checks were made by the organisation about their skills and suitability which included a police check. The organisation did not always obtain references previous employment to ensure that staff conduct in that employment was satisfactory.

People were supported to receive their medication as prescribed. Staff who supported people with their medicines had received training, to ensure people received their medicines safely.

People were supported by staff that had received the support they needed so that they could carry out their role effectively.

People were supported by staff that were kind and respectful. Where appropriate, people were supported by staff to access other health and social care professionals when needed.

People’s independence was respected and promoted and staff responded to people’s support needs. Most people felt they could speak with staff about their worries or concerns and that they would be listened to and have their concerns addressed.

People had access to food and drinks and were supported to have food that they enjoyed.

The provider had management systems in place to assess and monitor the quality of the service provided to people. However, records management was not always effective in relation to ensuring all information was accurately recorded.