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Inspection Summary


Overall summary & rating

Good

Updated 25 December 2018

This announced inspection took place on 20 and 28 November 2018.

Flexserve UK Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to adults of all ages, including people with dementia, learning disabilities or autistic spectrum disorder, mental health needs and physical disabilities.

Not everyone using Flexserve UK Limited receives a regulated activity. The Care Quality Commission (CQC) only inspects the service being received by people provided with personal care, which is help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection there were 39 people using the service in this respect.

The service had a registered manager. This 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.

At our last inspection of this service, in March 2018, we found four breaches of legal requirements. These were in respect of staff deployment and training, safeguarding people using the service from abuse, notifying CQC of allegations of abuse, and good governance. The service was rated ‘Requires Improvement’ and we served the provider an enforcement warning notice for the staffing breach. The provider sent us an action plan in respect of the breaches. We undertook this inspection to check that the action plan had addressed the breaches. This was also a comprehensive inspection, to make sure the service was providing care that is safe, caring, effective, responsive to people's needs and well-led.

At this inspection, we found improvements had been made in all our previous areas of concern, and so there were no longer breaches of regulations. This has helped to improve the service’s overall rating to ‘Good.’

The service was now ensuring sufficient numbers of suitable staff were deployed to support people

to stay safe and meet their needs. Reasons for this improvement included better scheduling of staff visits and through ensuring staff visit times were being electronically monitored. Staff visits to people’s homes were therefore more punctual and people’s preferred visit times were being more respected.

The service was now making sure staff had the skills, knowledge and experience to deliver effective care and support. New care staff now completed all parts of a national training program, and established staff received regular refresher training. Staff capability was starting to be practically assessed on key topics, as well as through knowledge tests. Staff were also now receiving regular developmental supervision, support and annual appraisal.

Processes and practices had now been improved to minimise the risk of people being abused and ensure staff responded appropriately if abuse was suspected or reported. The service was also now reporting allegations of abuse to CQC as legally required, which helps with ensuring appropriate regulation of the service.

Governance processes and audits were now effective as they were identifying service delivery shortfalls. The provider was acting on these, to improve on outcomes for people using the service and ensure the service’s sustainability.

However, the rating for ‘Is the service safe?’ remains ‘Requires Improvement.’ This is primarily because where people had more complex needs, assessment of risks was not always comprehensive. Additionally, medicines support plans did not fully reflect the support required for people with highest needs, and administration records were not consistently accurate and comprehensive. The service was taking steps to address these matters.

Most people fed back positively about the service. Some rated it as, “Ten out

Inspection areas

Safe

Requires improvement

Updated 25 December 2018

The service was not consistently safe. Information about risks and safety was not always comprehensive for people with more complex needs. Medicines records did not fully reflect the support required for people with highest needs. However, the service was taking steps to address this.

Improvements had been made to ensure that processes and practices safeguarded people from abuse, and that there were enough suitable staff to support people to stay safe and meet their needs.

The service�s procedures protected people from the risk of infection.

Systems were in place to ensure that ongoing learning took place in response to accidents and incidents.

Effective

Good

Updated 25 December 2018

The service was effective. There were now systems to help ensure staff had the skills, knowledge and experience to deliver effective care and support.

People's needs were holistically assessed, to help ensure the service could meet their specific needs.

The service worked in co-operation with other organisations to deliver effective care and support.

Where appropriate, the service supported people to eat and drink enough, maintain good health and access appropriate healthcare services.

Consent was obtained before personal care was provided. Where anyone could not make that decision, it was assessed in line with the Mental Capacity Act 2005.

Caring

Good

Updated 25 December 2018

The service was caring. It ensured that people were treated with kindness, respect and compassion, and that they were given emotional support when needed.

The service ensured people�s privacy and dignity was respected.

People were supported to express their views and make their own decisions about their care and support. Their independence was promoted.

People were supported by committed staff that built positive working relationships with them.

Responsive

Good

Updated 25 December 2018

The service was responsive. It enabled people to receive personalised care that was responsive to their needs.

The service listened and responded to people�s concerns and complaints, and used this to improve the quality of care.

Well-led

Good

Updated 25 December 2018

The service was well-led. The provider�s governance systems were now helping to ensure a quality service was being provided. The way the service was now operating enabled sustainability and supported continuous learning and improvement.

The service promoted a positive and inclusive culture that achieved good outcomes for people.

People, their families and staff had opportunities to help develop the service.