We carried out a review of the data available to us about Care Select on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Care Select, you can give feedback on this service.
Care Select is a domiciliary care agency providing personal care to approximately 75 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
People and their families told us without exception they felt safe with the staff team with staff and management being reliable and supportive. They told us staff supported them with medicines in a timely manner and were equipped to ensure personal protective equipment (PPE) was used at all times during the ongoing COVID-19 pandemic. New staff underwent appropriate recruitment checks to ensure their suitability to support vulnerable adults.
People told us that while they had not had to make a complaint; they were aware of how to do this and were confident that their concerns would be listened to and acted upon. People were aware of the contents of their support plans. They had the opportunity to contribute to these and to influence their support. These plans were person-centred and regularly updated when and if needs changed. The limitations some people had with their senses were taken into account within support plans and in staff interactions.
The governance of the service had improved following our last visit. People felt as though they were supported by a well-led service and were complimentary of the staff and the management team. They were involved in commenting about their care on a regular basis. Staff felt supported and that the management team listened to them. Staff practice was monitored regularly and despite pandemic restrictions; staff had maintained contact with their respective manager.
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 3 April 2020).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
This was a planned inspection based on the previous rating. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Care Select 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.
The service is a domiciliary care agency which provides personal care to people living in their own homes. At the time of this inspection there were 42 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
There were shortfalls in the leadership and management of the service which exposed people to the risk of harm. There was an audit system in place, but these quality checks had not been effective enough to fully identify and address concerns found on this inspection. The registered provider had made organisational changes and a new manager was due to start at the service. They spoke to us about the changes they planned to make to ensure that oversight was more robust.
Improvements were needed to ensure the safety of the service. This included the improvements to the management of medicines and the safe recruitment of staff. The specific risks people faced were not always fully recorded. Relatives felt their family members were safe receiving support from staff, who knew them well.
People were supported by trained staff who provided a reliable, person-centred service. Staff were kind and respectful towards people and their families and people's privacy and dignity were upheld. People's
independence was encouraged, and they were involved in decision making.
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 used to support people to make decisions were not recorded appropriately and we have made a recommendation in respect of this.
Complaints were not always recognised and responded to. However, there was a good working relationship between people who used the service, their relatives and the staff.
There was collaborative working with external professionals to ensure people got any extra support they needed. The service was changed as required to meet people's varying needs and wishes. We made a recommendation regarding addressing people’s specific communication needs.
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 good (published 24 October 2018). The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have four identified breaches in relation to the safe management of medicines and risk, safe recruitment and overall management of the service.
Please see the action we have told the provider to take at the end of this report.
The provider had failed to notify the Commission about incidents they are required to do by law. This is a breach of regulation. Full information about CQC's regulatory response to this is added to reports after the processes outside inspection 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
On the days of this inspection there were 52 people using the service, supported by 34 staff.
This was the first inspection of this service which was registered with the Care Quality Commission on 9 June 2016.
There was a registered manager in place at this 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 told us they were very happy with the service provided and that the staff were caring, kind and brilliant. People said “The staff are very good”, “The staff know [Name] very well”, “The staff do a very good job” and “I am very happy with the service provided.”
Staff had received a range of training that included moving and handling, safeguarding, medication and fire awareness, however, this needed to be brought up to date. Staff supervision sessions, annual appraisals and staff meetings had occurred on an ad-hoc basis. A recommendation was made regarding this.
Quality assurance processes were not robust. Audits of care folder documentation were not up to date and telephone monitoring calls to people who used the service had not been completed. A recommendation was made.
Staff told us they enjoyed working at the service and providing support to people who used the service. They said they were supported by the office and management team.
Care plans were well documented and up to date. They gave clear guidance to the staff team. Risk assessments were undertaken for a variety of tasks which included moving and handling, falls and the environment. These were reviewed regularly and up to date. The management of medication was safe.
Staffing rotas showed that sufficient staff were employed to cover the hours required to meet people’s needs.
Staff were aware of how to report a safeguarding concern. They were aware of the policies and procedures available to safeguard people from harm and told us they would not hesitate to report any concerns.
Staff recruitment files showed that good recruitment processes were in place. Staff attended an induction process prior to working alone. Staff told us that they worked alongside an experienced staff member before going it alone. They confirmed the induction process was good and that they had the information they needed to perform their role.
People had access to information about the service. They said that they knew the information was in their care folder and some people had read this. An initial visit was undertaken by one of the staff team prior to the service starting.
A complaints policy was available and each person had this information within the care folder. Processes were in place to deal with any complaints received.
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.
Further information is in the detailed findings below.