Quality Support Solutions Limited

Updated 18 February 2020

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team:

The inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type:

Quality Support Solutions Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

We gave the service two working days’ notice of the inspection. This was because it is a small service and we needed to be sure that the registered manager would be in the office to support the inspection.

The inspector visited the office on 14 January 2020 to see staff and to review records. The Expert by Experience spoke with people and relatives by telephone on the same day; to ask them about their experience of using the service.

What we did before the inspection:

We reviewed information we had received about the service since the last inspection and sought feedback from one of the local authorities who work with the service.

We used all of this information to plan our inspection.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection:

We spoke with five people using the service and four relatives. We spoke with the registered manager who is also the nominated individual, one senior support worker and two support workers. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We looked at various records, including care records for five people, as well as other records relating to the running of the service. These included staff records, medicine records, audits and meeting minutes. This was so we could corroborate our findings and ensure the care and support being provided to people were appropriate for them.

After the inspection:

We continued to seek clarification from the registered manager to validate evidence found. We requested information about staff training, records about people’s care visit timings and quality monitoring checks. We also sought feedback from a second local authority who works with the service.

Updated 18 February 2020

About the service:

Quality Support Solutions Limited is a domiciliary care agency. It provides personal care to adults living in their own homes, so that they can live as independently as possible.

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 this inspection 42 people were using the service, 22 of whom were receiving personal care. People had a variety of care and support needs including learning disabilities, autistic spectrum disorders and physical disabilities.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them. For example, staff did not wear uniforms and were discouraged from wearing anything that suggested they were care staff when coming and going with people.

People’s experience of using this service:

Since the last inspection a number of improvements had been made. This included the provider’s internal systems to monitor the quality of service provision and to drive continuous improvement. However, we identified some areas requiring improvement during the inspection that had not been fully identified by the provider. This included the planning and timing of care visits, staff recruitment checks and the actions taken when someone runs out of their medicine. This showed that the provider’s systems required further strengthening to ensure all legal requirements are consistently identified and met.

Despite this, people we spoke with told us the care and support they received was generally reliable and helped to improve their quality of life. They said staff provided care and support in a kind, compassionate way and their privacy, dignity and independence was respected and promoted.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Staff knew how to protect people and keep them safe. They had the right skills and knowledge to meet people’s needs. Staff maintained good standards in relation to infection control and hygiene, and supported people to stay healthy too. They helped them to access healthcare services when they needed them and ensured they had enough to eat and drink.

People were given the opportunity to make suggestions and provide feedback about the service provided to them. Systems were in place for people to raise any concerns or complaints they might have about the service. Feedback was responded to in a positive way, to improve the quality of service provided.

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 Requires Improvement (published 17 January 2019).

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Quality Support Solutions Limited on our website at www.cqc.org.uk.

The provider completed an action plan following that inspection to show what they would do and by when to improve. At this inspection we found enough improvements had been made and the provider was no longer in breach of regulations.

However, pending additional improvements, the service remains rated requires improvement. This is the second time the service has been rated requires improvement.

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make further improvements. Please see the safe and well-led key question sections of this full report. We found no evidence during this inspection that people were at risk of harm from these concerns.

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.