Archived: Person Centred Care and Support LLP

Updated 8 July 2021

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 29 October and 13 November 2018. The first day of the inspection was unannounced. We informed the provider of the second day of the inspection.

The inspection was carried out by two inspectors.

Prior to the inspection we reviewed the information we held about the service, including information shared with us by the local authority and members of the public. We also reviewed statutory notifications sent to us by the provider. A statutory notification is information about important events which the service is required to tell us about by law. We used this information to plan our inspection.

During the inspection we spoke with one person who used the service, three care staff and the manager. We looked at three people’s personal care and support records, three people’s medicine administration records, the recruitment records for two staff, policies and procedures, audits and other records relating to the management of the service.

After the first day of the inspection we contacted two relatives and a healthcare professional to gather their views of the service. After the second day of the inspection we were contacted by numerous staff of the service to complain about their conditions of work.

Updated 8 July 2021

This comprehensive inspection took place 29 October and 13 November 2018 and was unannounced.

Person Centred Care and Support LLP provides care and support to people living in residential houses, split into flats. At present the service has two 'supported living' settings, so that people can live in their own home as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate the premises used for supported living; this inspection looked at people's personal care and support. People were supported with their personal care needs at one site operated by Person Centred Care and Support LLP, Compton Crescent.

Following the last inspection on 28 March 2018, we made a recommendation about the safer management of medicine. We also found a breach in Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) 2014, Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) 2014 and Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) 2014.

At the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions Safe, Effective, Responsive and Well-led to at least good. At this inspection, we found they had not met their action plan and there continued to be systematic failings in the oversight and management of the service.

The service did not have a registered manager in place. 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. During our inspection, the manager of the service resigned.

The provider of the service continued to disregard the conditions of their registration with the Commission. The service moved offices in August 2018 but the provider did not inform us, nor make the necessary changes to their registration. We continued to have grave concerns about the ongoing financial viability of the provider organisation, due to their failure to provide the resources staff needed to be able to support people, to maintain an office and to pay their staff.

People continued to receive support from staff who were kind and compassionate, but were inexperienced and unqualified for the types of work they were carrying out. Staff received training in topics of relevance to their work, however their inexperience meant they were not able to apply their learning and ensure they provided safe, high-quality care that protected people’s rights. The service did not always follow the principles of safer recruitment to ensure that staff were suitable to work with people in need of support.

The provider did not have systems in place to ensure that people were able to consent to their care and support in line with the requirements of the Mental Capacity Act 2005. Assessments of people’s capacity to consent to their care were not carried out, and care was agreed by people’s relatives without proof of their legal authority to consent on the person’s behalf.

Medicines were not managed safely. Accidents and incidents were not appropriately recorded and reviewed to reduce the likelihood of reoccurrence. Risks relating to people’s support were not identified and mitigated, and the staff were not skilled at supporting people to manage their behaviours that others may find challenging and learn more community-appropriate behaviours.

The service did not undertake an assessment of people’s needs before they moved in, or at any time afterwards. As such, care and support was not designed and delivered to meet people’s needs. The inexperience of the staff also meant that people were not always treated with dignity and respect.

Records relating to the management of the service continued to be unavailable or inaccessible, including to the manager. Complaints were not recorded or responded to appropriately, and were not used as opportunities to identify and make improvements to the service people received.

The provider did not have an established system in place to assess, monitor and improve the service. People, their relatives and other professionals involved in people’s support were not asked for the feedback. The service did not work in partnership with other agencies.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

During this inspection we found eight breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and two breaches of the Care Quality Commission (Registration) Regulations 2009. We also identified a breach of s.33 of the Health and Social Care Act 2008.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.