Quality Assured Care Services Ltd

Quality Assured Care Services is a domiciliary care agency providing personal care to people in their own homes. At the time of our inspection there were 42 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

Staff received safeguarding training and understood their responsibilities to report potential safeguarding concerns to the registered manager. Risks to people’s health, safety and wellbeing were assessed and formed part of a needs assessment. This information was used to develop care plans and guide staff on how to manage those risks. Systems were in place to ensure the safe recruitment of staff. This included references and Disclosure and Barring Service (DBS) checks. Staff received training in medicine administration and their competency was assessed. Only staff assessed as competent could support people with their medicines. Staff understood and followed safe infection control guidelines and knew how to minimise risks of infection.

We received positive feedback from people about Quality Assured Care Services. People felt well cared for and looked after. The provider used audits to monitor and improve the quality and safety of care. Some of these audits could be improved to ensure they gathered information that was valuable to the service in order to identify where improvements could be made. Surveys were used to gather feedback from staff and people about the service. The results were analysed and used to make changes in response. The provider and staff worked with other health and social care professionals to improve people’s outcomes, and ensure people received care and treatment that was relevant to their changing needs and circumstances.

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 2 September 2019).

Why we inspected

This inspection was prompted by a review of the information we held about the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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

Follow up

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

Quality Assured Care Services Ltd is a domiciliary care agency. It is registered to provide personal care to people in their own homes, including people with dementia, physical disability or sensory impairment. At the time of the inspection visit the service supported 33 people.

People’s experience of using this service:

People felt safe using the service and staff understood how to recognise and report abuse. Staff recruitment processes included background checks to review their suitability to work with vulnerable adults.

Some events which called into question people’s safety were not always recorded and managed properly and risks to one person’s safety had not been fully assessed. However, improvements were made straight after our visit.

People received support from staff when needed and they were supported to have their medicines as prescribed. People were supported to have enough to eat and drink to maintain their well-being. Most people were supported to obtain advice from healthcare professionals when required.

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 were treated with dignity and their independence was promoted wherever possible. Staff provided care to people at the end of their lives.

People were involved in planning their care with support from staff. People and their families understood how to complain if they wanted to. The provider and the registered manager were open and honest, and worked in partnership with outside agencies to improve people’s support when required. There were checks in place to ensure good standards of care were maintained.

Rating at last inspection and update: The last rating for this service was requires improvement (published 8 August 2018) and there was a breach 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:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

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

This was the first inspection of the service since its registration with us in October 2017. The service was previously registered under a different address.

Quality Assured Care Services Ltd is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to adults with different needs, including dementia, physical disabilities and sensory impairments. The service provides twenty four hour support to four people. There were 31 people using the service at the time of our inspection visit.

At this inspection we found improvements were required. The provider had not ensured that systems were in place to effectively assess, monitor and mitigate the risks relating to the health and safety of people who used the service. They had not maintained accurate and complete records for people and their governance system did not ensure their practice was always evaluated or improved. We have rated the service as ‘Requires Improvement’ in the key questions of safe, effective, responsive and well-led and ‘Good’ in the other key question. Therefore the service is rated as ‘Requires Improvement’ overall.

There was a registered manager in post. 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 understood their responsibilities to protect people from the risk of harm, however some staff had limited knowledge of local authority adult safeguarding procedures. The provider had not referred one event which called into question people’s safety, to the CQC. We found some risks to people’s health and safety had not been properly assessed to reduce the risk of them happening in the future.

There were gaps in the provider’s understanding of their responsibilities in relation to the Mental Capacity Act 2005 [MCA] and improvements were required to ensure people’s capacity was assessed where required and consents were obtained in accordance with the MCA.

Processes to monitor the quality of service were not effective and improvements were required to ensure care plans were accurate and people were kept safe.

Care plans were not always accurate. We found some identified risks relating to people’s needs had not been assessed in full on their care plans.

People decided how they were cared for and supported. However, improvements were required in recording people’s preferences and ensuring care plans were personalised. People knew how to complain and were able to share their views and opinions about the service they received.

Staff knew people well and knew how they wanted to be cared for and supported. Staff respected people’s right to privacy. There were enough staff to meet people’s needs. People were supported to maintain their health and diet and they received their medicines as prescribed.

The provider had worked closely with commissioning authorities to make improvements to the service and people were satisfied with the service. Staff felt supported by the provider.

We found a breach of the Health and Social Care Act 2008 (Regulated activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.