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Smart Care Services NW Limited Good

Reports


Inspection carried out on 17 September 2019

During a routine inspection

About the service

Smart Care Services NW Limited is a domiciliary care agency, providing personal care to people in their own houses or flats. At the time of inspection, the service supported 192 in Warrington and surrounding areas.

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’s experience of using the service was overall positive. We found, some improvements were needed with regards to meeting regulatory requirements, however the provider addressed these immediately. Smart Care Services NW Limited is an independent provider and we recognised they had significantly invested into developing their quality assurance systems following our last inspection. This had led to improvements, but some newer aspects of governance still needed to embed and develop to be effective at ensuring consistently high-quality care.

We have made a recommendation about staffing. When we assessed the service, we considered the individual experience of people, relatives and staff and looked at these in proportion to the size of the service. For example, the large majority of people received their care calls on time or mostly on time. Some people felt call times and consistency of staff were not always reliable. However, we also heard this had improved and the registered manager was reviewing all care call routes to provide greater consistency. We made a recommendation regarding effectively supporting people to take their medicines at the right time.

Overall, we heard positive comments from people and relatives about care staff. Although some people noted variation in standards and room for improvement, others praised staff highly, for the way in which they engaged with people and supported their independence. All of the staff we spoke with praised the positive culture of the service, its leadership and the support provided. This was evident in the fact that several staff had left to go to a different provider but chose to return. The service worked in partnership with different professionals to promote people’s health and wellbeing. Stakeholder feedback noted continued improvement, with some areas of inconsistencies to address.

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 8 August 2018).

At the last inspection we found the provider was in breach of regulations, as governance systems had not always been effective. 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.

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.

Inspection carried out on 19 July 2018

During a routine inspection

This inspection took place on 19 and 20 July 2018 and was announced.

Smart Care Services NW Limited is a domiciliary care agency. It provides care to people living in their own houses and flats in the community. It provides a service to older adults. At the time of the inspection the registered provider was providing support to 147 people.

Not everyone being supported by Smart Care Services NW Limited received personal care. The Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’, help with tasks relating to personal hygiene and eating. We also take into account any wider social care provided.

There was a registered manager in post at the time of the inspection. A ‘registered manager’ is a person who has registered with CQC 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.

This was the first comprehensive inspection of Smart Care Services NW Limited since their registration with the Care Quality Commission in April 2017.

Quality assurance and governance systems were not effectively in place. Audits and checks were not assessing, monitoring or identifying areas of improvement that were needed. We found care plan and risk assessment audits to be ineffective, records and documentation were not appropriately completed and processes to gauge feedback needed to be developed.

You can see what action we told the provider to take at the back of the full version of the report.

Medication management procedures were in place and staff were familiar with the importance of complying with medication policies. Staff were trained in the administration of medication and ‘spot checks’ were completed to monitor and assess the competency levels of staff. Topical (medicated) creams were safely applied and people were administered the medication they required. We did identify that PRN (‘as and when’ needed medication) protocols needed to be reviewed.

We recommend that the registered provider reviews their PRN policies and procedures, ensuring people receive PRN medication in the safest way.

Care plans and risk assessments were in place and staff were familiar with the support needs of people they were supporting. We received positive feedback from people, relatives and healthcare professionals about the level of safe care that was provided and how risks were managed.

Recruitment processes were safely in place. The registered provider ensured that staff who were employed were suitable to work with vulnerable adults. Disclosure Barring and System (DBS) checks were conducted prior to employment commencing.

Staffing levels were safely managed and people received the level of care and support expected. We were informed that all scheduled support visits took place and staff ‘generally’ arrived on time. Relatives and people who received support said that staff would always inform them if they were going to arrive later than expected.

‘Accident and Incident’ reporting procedures were in place. There was an up to date ‘Accident Reporting’ policy and staff were familiar with the necessary reporting procedures. The registered provider ensured that all incidents involving people who were supported, medication and safeguarding were routinely recorded and trends were established accordingly.

Staff were knowledgeable in the area of safeguarding and whistleblowing procedures. Staff had received the necessary safeguarding training which meant that people were protected from harm and abuse. Staff knew how to report any concerns and who to report their concerns to.

Health and safety policies and procedures were in place. Staff were provided with personal protective equipment (PPE) and they were aware of the different infection prevention control procedures that they needed to follow. The regi