Embrace UK Community Support Centre

Embrace UK Community Support is a domiciliary care agency providing personal care to people living in their own home. At the time of the inspection the service was supporting 22 people with personal care

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.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic

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

Right support

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 lived at home with family members who told us their relative was safe with care staff.

People had their risks assessed to reduce the risk of potential harm to them. Recruitment checks were carried out to ensure staff employed were safe to work with people. Systems were in place to report and learn from any incidents

Right care

The care was person-centred and promoted people’s dignity, privacy and human rights. Most relatives told us staff were kind and caring towards their relative and treated them with dignity and respect. People were supported to maintain their privacy, dignity and independence by a staff who knew them well. Staff were matched to people based on their skills, qualities and interactions with people who used the service. Staff training was not always effective. We have made a recommendation in relation to staff training.

People had their communication needs met and information was shared in a way that could be understood. People were supported to access food and drink that met their dietary needs and wishes. People were supported to stay healthy and well, and to access community health and social care services as and when required.

Right culture

Relatives told us the registered manager was approachable and took action to resolve issues where needed. Staff told us they were well supported by the registered manager and were listened to and encouraged to discuss their views regarding the service.

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 27 October 2020) and there were breaches of regulation. 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

We carried out an announced focused inspection of this service on 27 August 2020 and 02 September 2020. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, good governance,

We undertook this comprehensive inspection to check they had followed their action plan and to confirm they now met legal requirements.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Embrace UK Community Support is a domiciliary care agency providing personal care to people living in their own home. At the time of our inspection there were 100 people using the service. 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

We received concerns about safeguarding, risk management, staffing and staff training, complaints, infection control, missed and late calls and the management of the service.

People and most relatives told us they felt safe using the service. Although relatives knew who to contact if they felt their relative was unsafe, people using the service were not sure who to talk to.

Staff did not always understand their responsibilities in reporting and acting on abuse.

Risk assessments lacked details on how to reduce risks to people with specific health needs.

We have made a recommendation in relation to the management of medicines.

Accidents and incidents were not always recorded in line with the providers policies and procedures.

People and relatives told us staff followed good infection control practices when providing care.

Systems for monitoring the quality of the service were ineffective in ensuring records related to care and treatment were up to date.

The provider failed to notify CQC of a notifiable incident involving an allegation of abuse.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 24 May 2018).

Why we inspected

We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about risks related to safe care and treatment, complaints, staff training and management of the service. A decision was made for us to inspect and examine those risks.

We inspected and found there was a concern with the way safeguarding concerns were raised and the management of risks related to safe care and treatment, so we widened the scope of the inspection to become a focused inspection which included key questions from safe, effective, responsive and well-led.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Good to Requires Improvement. 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 Embrace UK Community Support Centre on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to complaints, risk assessments, staffing levels and staff recruitment, staff training and supervision and governance systems at this inspection.

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.

Follow up

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

This inspection took place on 23 and 25 April 2018 and was announced. This was the first inspection of this service since they became registered in 2012. The service has only been operational for nine months.

There was a registered manager for the service who was also the provider. 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.

Staff were knowledgeable about safeguarding and whistleblowing procedures. The provider had safe recruitment processes in place. There were enough staff to ensure visits to people were not missed. Risk assessments were carried out to mitigate the risks of harm people may face. There were systems to manage people’s medicines. However, medicines taken as needed were not always fully recorded. People were on the whole protected from the risks associated with the spread of infection but occasionally staff did not have access to enough personal protection equipment.

People had an assessment of their needs to ensure the provider could meet their needs. New staff received induction training at the start of their employment and staff were offered refresher training to maintain their skills. Staff were supported with regular supervisions to ensure they could deliver care effectively. People were supported to eat a nutritionally balanced diet and to maintain their health. The provider and staff knew about their responsibility to obtain consent from people before delivering care.

Staff described how they developed caring relationships with people they supported. People and their relatives were included in the care planning process. Staff were knowledgeable about equality and diversity. People’s privacy and dignity was promoted and their independence was maintained.

Care records were personalised and contained people’s preferences. Staff understood how to deliver a personalised care service. The service had a complaints procedure. People and their relatives knew how to make a complaint if they were not happy with any aspect of the service.

People and their relatives spoke positively about the management of the service. The provider had a system to obtain feedback from people and their relatives about the quality of the service in order to make improvements where needed. Staff had regular meetings so they could contribute to the development of the service. The provider carried out spot checks and quality assurance checks of the work of staff to monitor the quality of the service being delivered. The provider worked with other agencies to share good practice and find ways to make improvements to their service.

We have made three recommendations regarding safe management medicines, controlling the risk of spread of infection and effective quality assurance.