Superb Healthcare

Superb Healthcare is a domiciliary care agency. The service provides support to older people, younger adults, people living with physical disability, dementia, mental health needs, sensory impairment and the misuse of drugs and alcohol. Staff provide personal care to people living in their own homes and supported living settings. 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 18 people using the service were receiving personal care, supported by 28 staff.

People’s experience of using this service and what we found

The provider could not provide required documentation to demonstrate there were enough staff to meet people’s needs safely. Whilst staff always sought consent before delivering people’s care, records did not show consent to their care had been sought in accordance with the Mental Capacity Act. Care plans did not contain required information in line with the Equality Act 2010, to enable staff to provide person-centred care. Records did not demonstrate people and relatives’ involvement in their care planning. The registered manager had not identified breaches of regulation in relation to staffing, the need for consent and person-centred care planning, which exposed people to potential risk of harm.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

People were protected from avoidable harm and experienced safe care from suitably recruited staff, who had been trained to recognise different types of abuse. Staff promoted people’s independence whilst effectively mitigating risks to keep them safe. People were supported to take their prescribed medicines safely by staff who prompted and reminded them, in line with their medicines support plans. People were protected from the risk of infections because staff delivered care in accordance with the provider’s infection prevention and control policy. The management team analysed accidents and incidents to identify and implement required learning.

People's needs were assessed before they received care to ensure their support needs could be met by the service. People experienced care and support from staff who had been enabled to develop and maintain skills relevant to their role. Staff supported people to eat and drink enough to protect them from the risks associated with malnutrition and dehydration. Staff worked effectively with other health care professionals to effectively access health care services and live healthier lives.

People experienced caring, meaningful relationships with staff who consistently treated them with kindness and compassion. Most people and relatives felt valued by the service and that their opinion mattered. People were treated with dignity by staff who respected their privacy and embraced their diversity and individuality.

The management team promoted a positive culture within the service, where people and staff felt valued, focused on delivering good care. The registered and deputy managers were proactive and responsive, ensuring the service achieved good outcomes for people, their relatives and staff. The management team assumed responsibility when mistakes had been made and understood their responsibilities to inform people when things went wrong. Staff experienced good support from the management team, who were readily available to provide guidance. Staff felt comfortable to voice concerns, which they were confident would be addressed. The service collaborated effectively with other agencies, including occupational therapists, hospital discharge teams, social workers and other care providers to ensure people experienced good outcomes.

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 (report published 11 July 2022).

At our last inspection we recommended that the provider seek advice and guidance from a reputable source about the development of individualised, person-centred care plans. The provider had failed to make improvements.

Why we inspected

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

Enforcement and Recommendations

We have identified breaches in relation to staffing, need to consent, person centred care planning 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 request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

This was an announced inspection which took place on 11 July 2018.

Superb Healthcare Ltd is a domiciliary care agency. It provides personal care to people living in their own homes. It currently provides a regulated activity to 13 people with various needs.

This was the first inspection of the service which was registered on 12 July 2017.The service was rated as good in four domains and requires improvement in safe. This means the service is overall good.

Why the service is good.

There was a registered manager running the 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, staff and visitors were generally protected from any form of harm and their safety was carefully considered. Any risks were identified and action was taken to reduce them, as far as possible. However, some risk assessments lacked enough detail to support staff to offer the safest care.

Staff had been trained in safeguarding vulnerable adults and health and safety policies and procedures and understood how to protect the people in their care. People were prompted or reminded to take their medicines which they retained responsibility for. People were supported by care staff who had been safely recruited although there were some omissions in recruitment records.

The service made sure there were enough suitable staff to meet people’s needs safely and effectively. People were provided with the correct amount of staff time to meet the needs stated in their individual packages of care.

People were supported by care staff who had been appropriately trained and supported to enable them to meet people’s varied needs. Care staff were effective in meeting people’s needs as described in plans of care. The service worked closely with health and other professionals to meet people’s specific needs.

People were assisted to have maximum choice and control of their lives and care staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

People were supported by a caring staff team. Care staff built relationships with people and knew their needs. People were encouraged to be as independent as they were able to be.

Care staff were responsive to individual’s needs. People’s needs were reviewed regularly to ensure the care provided was up-to-date. Care plans included information to ensure people’s individual communication needs were understood. We made a recommendation relating to person centred care planning.

The registered manager was described as very approachable and supportive. The registered manager and the staff team were committed to ensuring there was no discrimination relating to staff or people in the service. The service assessed, reviewed and improved the quality of care provided, as necessary.