Archived: First Class Care Limited

What life is like for people using this service:

At the time of the inspection there was no registered manager at the service. There was a recruitment drive for care staff on at the time of the inspection, but we found the recruitment process was not robust or following the provider’s recruitment policy. Personal data was not processed in accordance with the General Data Protection Regulations (GDPR) and relevant data protection law. There were clear monitoring systems to support the service and ensure it was run well. Call monitoring was robust and this identified the call time and duration of the call. There was an open and transparent culture throughout the service. The acting manager submitted notifications to CQC in a timely manner. Positive feedback on how the service was managed was received from people, family and other healthcare professionals.

We have made a recommendation about the management of staff files and General Data Protection Regulations.

First Class Care limited provides care for people living in their own homes.

People told us they felt safe and protected from harm with the staff that cared for them. Robust assessments were in place to identify people’s known risks and ensure people and staff, were aware of these to make sure any risks taken were done so safely. There was sufficient staff to care for the number of people using the service at the time of the inspection. Medication was managed in a safe way and people received their medicines as prescribed. There was evidence of investigations when things went wrong and lessons learned from outcomes. Staff were reporting incidents and concerns.

Rating at last inspection: Requires improvement (10 September 2018)

Why we inspected: This was a responsive inspection. We responded to concerns raised with us regarding the financial viability of the company.

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

There was a registered manager in post at the time of our inspection. 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.

At the time of the inspection, 28 people received some support with their personal care. This is the service’s second inspection under its current registration. At the previous inspection, the service was rated as ‘Requires Improvement’ overall. At this inspection, they have remained at this rating and we identified one breach of the Health and Social Care Act 2008 (Regulated Activities). You can see what action we have told the provider to take at the end of this report.

The risks to people’s health and safety had not always been appropriately assessed. This included how to evacuate people safely in an emergency. There were enough staff to support people safely; however, no monitoring of staff arrival times took place. This led to some people experiencing late calls. Robust staff recruitment processes were in place. The process for the reviewing of accidents and incidents was not always effective. People told us staff made them feel safe when they supported them. People’s medicines were managed safely. Staff understood how to reduce the risk of the spread of infection, although some staff had not yet completed infection control training.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; however, the policies and systems in the service did not always support this practice. Staff received an induction and training programme, however not all staff had completed all required training or completed the Care Certificate within a reasonable timeframe. People’s care was provided in line with current legislation and best practice guidelines. People felt staff were well trained and understood how to support them. People’s nutritional needs were met and staff supported people effectively with their meals where needed. Other health and social care agencies were involved where further support was needed for people.

Most people felt staff were kind and caring, treated them with respect and ensured their dignity was maintained. Relatives spoken with agreed. People were encouraged to do as much for themselves as possible and were involved with decisions about their care.

Prior to starting with the service, assessments of people’s needs were carried out to enable staff to support them effectively. People’s care records contained details of their personal preferences. People told us staff supported them in the way they wanted. People felt staff responded to their complaints effectively, records viewed confirmed this. People’s diverse needs were discussed with them during their initial assessment and then during further reviews. End of life care was not currently provided by the service.

The quality assurance processes that were in place had identified the issues we raised during the inspection; however, action had not yet been taken to address them. People’s views were gained on how to develop and improve the service; however, a formal annual survey had not yet been sent to people. This meant the provider was unable to formally assess the performance of the service over the last 12 months. The registered manager carried out their role in line with their registration with the CQC. Notifiable incidents were reported to the CQC.

The service had a registered manager, although they were no longer employed by First Class Care. A new manager had been appointed who told us they intended to register. 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 that they felt safe when receiving support from the staff and staff understood their responsibilities to protect people from the risk of abuse. Risks to people’s health and safety were not always appropriately assessed which meant that steps had not been taken to mitigate risks.

There were not sufficient staff available to ensure that all calls could be allocated and any unplanned absences were covered. Additional staff were being recruited at the time of our visit. People received any support they needed to manage their medicines.

Staff were provided with the knowledge and skills to care for people effectively and felt supported. People were asked for their consent prior to any care being delivered.

People received the support they required to have enough to eat and drink and, where required, staff supported them to access healthcare professionals.

People were cared for by staff who had developed caring relationships with them. People, or a relative, were able to be involved in planning their own care and making decisions. People were treated with dignity and respect by staff who understood the importance of this.

People received person-centred care and staff generally arrived within the agreed timeframe. People could be assured that any complaints they made would be taken seriously and appropriately responded to.

The culture of the service was open and honest and people, relatives and staff felt comfortable raising issues of concern. Insufficient staffing resources had meant that the provider and manager spent much of their time providing care. This had impacted upon their ability to provide clear leadership and direction to staff. The quality monitoring systems had not always been used effectively to bring about improvements to the service. Records relating to staff had not been stored securely.