Archived: Supreme Healthcare Services

Updated 10 June 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory function. The inspection checked whether the provider was 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 the 14 and 15 April 2015 and was announced. The manager was given 48 hours’ notice of the inspection as we needed to be sure that the office would be open and that care workers would be available to speak with us.

The inspection was conducted by two inspectors and an Expert by Experience who spoke with people using the service and their relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection we looked at the previous inspection reports and notifications received by the Care Quality Commission (CQC). A notification is information about important events which the service is required to send us by law. We also looked at the provider’s website to identify their published values and details of the care they provided.

The provider also completed a Provider Information Return (PIR). This is a form that asks the provider to give us key information about the service, what the service does well and improvements they plan to make.

We visited the agency’s office, met with three people at their homes, spoke with the manager, the quality improvement manager, three care workers and two relatives. We looked at four people’s care plans, daily care notes for two people, five care worker recruitment and training programme files, care worker rotas for the dates from the 23 March until the 12 April 2015, the care workers training plan, quality assurance audits. We also looked at the provider’s records for monitoring completed and/or missed care visits and policies and procedures. We also spoke on the telephone with an additional two care workers, four relatives and three more people who use the service.

The previous inspection was carried out in August 2013 and no concerns were raised.

Updated 10 June 2015

This inspection was announced and took place on the 14 and 15 April 2015.

Supreme Healthcare Services provides personal care and support to people who live in their own homes. At the time of the inspection they were providing personal care to 38 people.There was no 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 a have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People using the service told us they felt safe however care worker practices did not always reflect safe care. People’s safety had being compromised in a number of areas. This included being exposed to avoidable physical harm and the unsafe management of people’s medicines.

Care workers did not always demonstrate that they had the required knowledge to be able to safeguard people and report any concerns to the relevant safeguarding authority. There were not always personalised risk assessments in people’s care plans detailing actions that needed to be taken to ensure a person’s safety when care was being delivered.

There were insufficient staffing levels to ensure that people’s needs were being met safely. There were also insufficient contingency plans in place in the event of adverse situations such as poor weather conditions to ensure that people still received safe care. The provider did not have a system in place to ensure the continuous assessment of staffing levels to ensure they continued to meet people’s needs. When additional care workers were required the provider did not seek assistance from partner domiciliary care agencies to ensure there were always sufficient care workers to meet people’s needs safely.

The provider did not operate a safe and effective care worker recruitment system. People were put at risk because when Disclosure and Barring (DBS), criminal records checks revealed care workers had relevant records, no actions or risk assessments were in place to assess or mitigate against any risk.

Medicines were not always being provided to people by care workers in the way they were prescribed or wanted. The Medication Administration Records (MAR) were not completed correctly so it could not be established whether medicines had been administered to people.

Care workers demonstrated that they understood person centred care but were not supported by the provider or through training to deliver this. Care workers did not receive robust training upon induction and it was unclear what training they had, or had not received. Even though some care workers had received training in the Mental Capacity Act 2005 (MCA) they were unable to demonstrate their understanding about how it could affect the care they provided.

People had not always been supported by care workers to access, when needed, health care professionals. When risks had been identified and harm had been caused no health care professionals advice had been sought by care workers to maintain people’s safety and welfare.

The provider was not operating in the best interests of people using their service because their views and experiences, when negative, weren’t being addressed.

The provider’s vision and values for the service were not known or understood by the care workers and therefore could not be delivered to people using the services.

Quality assurance processes were in place but not being used regularly or effectively to gather, capture and then respond to concerns when they were received. People told us they weren’t able to get their concerns addressed when liaising with senior management.

We found there to be a number of continued breaches 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.

After the inspection the provider voluntarily submitted an application to remove Supreme Healthcare Services (Basingstoke) from their registration under Section 19 of the Health and Social Care Act 2008 (as amended).

This meant the provider would no longer be registered to conduct carrying out the regulated activity of personal care from this location.