We carried out a review of the data available to us about PIC 24 Healthcare Ltd 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 PIC 24 Healthcare Ltd, you can give feedback on this service.
People’s experience of using this service and what we found
People were safe. Staff had been trained to safeguard people from abuse. They understood the risks to people's safety and wellbeing and what they should do to minimise these. Staff were recruited in a robust and safe way to ensure they were suitable to support people. The service had infection prevention and control measures in place which were in line with current guidance. People received a consistent and reliable service, provided by regular staff with whom they were familiar.
People had the support they needed to manage and take their medicines safely. The management team reviewed any accidents or incidents involving people who used the service, in order to learn from these.
The registered manager and provider promoted a person-centred culture within the service. People’s care and support was delivered in a kind and caring manner. People and their relatives were encouraged to provide feedback about the service they received, so any improvements could be identified.
The provider had quality assurance systems and processes in place to enable them to monitor and improve people's care. Staff and management sought to maintain positive working relationships with the community professionals involved in people’s care.
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 (report published 7 November 2019). At this inspection we found improvements had been made.
Why we inspected
We carried out an announced inspection of this service on 16 October 2019. We found some improvements were needed and we rated the service requires improvement to the key questions of Safe and Well-led.
We undertook this focused inspection to check the provider had made improvements. This report only covers our findings in relation to the Key Questions Safe and Well-led.
For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall 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 PIC 24 Healthcare Ltd on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
PIC 24 Healthcare Ltd is a domiciliary care agency providing personal care to three 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. At the time of the inspection the registered manager and nominated individual were the sole employees, who were responsible for care delivered as well as the running of the service.
People’s experience of using this service and what we found
There was a governance framework in place but it wasn’t clear when some checks had taken place. Audits on care plans had not taken place and so errors identified during the inspection had not been identified. The service had a clear vision and has open communication with people, relatives and staff. People and relatives were regularly contacted by the registered manager to discuss the quality of their care. Staff were involved in meetings and decisions about the running of the service. The service worked with other service providers to support and share best practice, and with Sheffield Local Authority.
We have made a recommendation about the provider undertaking a review of their governance and audit processes.
Recruitment checks had not been carried out on new staff.
We have made a recommendation about the provider ensuring robust recruitment processes are in place.
Systems and processes were in place to safeguard people from abuse. Staff were knowledgeable about the signs of abuse and any actions they had taken were recorded and reported to the appropriate authorities. Risks to people were assessed and people were supported safely whilst maintaining their independence. Staffing levels were sufficient to support people’s needs. People were protected from infection by trained staff who had good access to personal protective equipment (PPE). Learning was considered from any incidents or occurrences, these were documented and shared with staff. Medicines were administered safely, however there was no evidence care plans were updated to reflect the changes in medication for one person although staff were knowledgeable about these changes.
We have made a recommendation about how the provider reviews and records changes in relation to people's care.
Care plans were personalised and reflected how people wished their care to be delivered. Concerns and complaints were recorded, action taken when needed and resolved with the input of the complainant. There was no one receiving end of life care at the time of our inspection.
We have made a recommendation about how the provider asks and records people’s end of life wishes.
People’s needs and choices were assessed and care plans were personalised. The registered manager was knowledgeable about MCA legislation. Staff received regular training and support. People were supported to eat and drink, where this was required, and their choices met. Staff had regular meetings to discuss care and support needs and worked closely with social workers, pharmacies and GPs to ensure people’s health needs were supported. Consent to care was recorded. 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.
People’s preferences were recorded and their was evidence these preferences were met. Daily records showed people’s privacy and dignity was respected and promoted.
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 18 October 2018). 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 in two areas and the provider was no longer in breach of regulations. However enough improvement had not been made in one area and the provider was still in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
This was a planned inspection based on the previous rating.
We have found evidence the provider needs to make improvements. Please see the safe and well-led sections of this full report.
Enforcement
We have identified breaches in relation to safe recruitment and 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.
There was a manager at the service who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run.
PIC 24 Healthcare Ltd was registered with CQC in June 2017. The registered manager told us the service started supporting people in February 2018.This was the service’s first inspection.
At this inspection we found the registered provider was in breach of three regulations.
People who used the service told us they felt safe. At the time of the inspection there were no recorded accidents, incidents and safeguarding concerns. The management team knew how to identify and report suspected abuse and had clear systems in place which ensured safety and legal standards were met.
We identified improvements to people’s care records were required, as not all support provided by staff was clearly documented. We found areas of risk which were not effectively managed or mitigated against, such as not always completing a relevant risk assessment when a risk had been identified. Feedback obtained during the inspection showed people received appropriate care and treatment.
People and their relative’s told us the service was very reliable and staff were well-trained and stayed as long as they should. We found people received support from the same staff which promoted good continuity of care. People told us the management team were exceptionally caring and always listened. We saw care records contained details about special dietary requirements but lacked detail about people’s food and drink preferences. We found the systems for obtaining consent before people received care and treatment were not always effective.
We saw evidence of a collaborative approach to planning people’s care and support. People told us they were provided a copy of their care plans which was reflective of their needs. We identified more detail was needed in people’s support plans in regard to more specialist support, such as catheter care. We saw the service had received no complaints since they began operating. At the time of our inspection, the service was not supporting anyone who required end of life care. People’s care plans did not refer to any aspect of end of life care. We have made a recommendation about advanced care planning.
People and relatives told us they thought the service was well-run and the management team were approachable and friendly. We found the registered provider’s systems or processes were not established and operated effectively to ensure compliance with the requirements of regulations.