Archived: VIP Care Solutions

The last comprehensive inspection took place in November 2016. The service was rated ‘Requires Improvement’ in the key question ‘Is the service Well Led?’ but ‘Good’ overall. We found a breach of Regulations relating to good governance. Following the inspection, we asked the provider to complete an action plan to tell us what they would do, and by when they would make the necessary improvements to meet the regulations. We then undertook an announced focused inspection in March 2017 to check that improvements to meet legal requirements planned by the provider after our November 2016 inspection had been made, and found that some improvements had been made but not enough to meet all the regulations.

This service is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to older people, people with learning disabilities, physical disabilities and mental health needs including dementia. At the time of the inspection, two people were receiving a service for the regulated activity of personal care.

The owner of the business was the Nominated Individual and registered manager, and ran the service with a relative, who was the service’s only care worker. 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.

During the inspection on 20 February 2018, we found safe recruitment procedures were not always followed as the provider could not evidence they had a second reference for the care worker to ensure they were suitable to work with people using the service.

Risk assessments and risk management plans were not robust enough to minimise risks to people using the service. For example one person at a high risk of falls did not have a falls risk assessment.

People were not always protected against the risks associated with the management of medicines. The medicines risk assessments were not up to date. Nor was the medicines training for the care worker or their competency assessment to manage medicines.

The registered manager and care worker, told us the care worker had up to date supervisions, appraisals, training and spot checks but they were unable to provide any written evidence of this happening. Therefore we could not be sure the care worker had the skills and knowledge to deliver effective care and support.

There was no information in people’s files indicating if they had consented to their care. However the care worker understood and supported people’s right to choose how they would like their care delivered and people using the service confirmed this. We recommended the provider follow guidance from reputable sources to better demonstrate how they comply with the principles of the Mental Capacity Act 2005.

The people we spoke with indicated that the care delivered was personalised and responsive to their needs but care plans were not always up to date and reviews did not have outcomes to reflect people’s current needs or how issues had been addressed. Therefore the care worker did not have guidelines to effectively care for people in a way that met their needs.

The provider had data management and audit systems in place to monitor the quality of the care provided. However records were not monitored effectively to ensure there were no gaps in the required information and there was an overall issue with administrative tasks and records not being organised or accessible when needed.

The provider had policies and procedures in place to safeguard people from abuse and the care worker knew how to respond to safeguarding concerns to help ensure people received care safely. There had not been any incidents or accidents with the service, but there were procedures in place to manage any incidents or accidents.

The provider had an infection control policy in place and the care worker understood how to protect people against the risks of the spread of infection.

People’s dietary requirements were met and the care worker knew how to support people to maintain good health.

The people using the service said the care worker was kind and caring and spoke well of them. People were involved in their care planning.

The provider had not had any complaints, but had a complaints procedure to record, investigate and follow up complaints in a timely manner.

The registered manager was available to people using the service and the care worker, and listened to their concerns.

We found five breaches of regulations during the inspection. These were in respect of safe care and treatment, staffing, person centred care, fit and proper persons employed and good governance. You can see what action we told the provider to take at the back of the full version of the report.

We undertook this focused inspection on 20 March 2017 to confirm that the provider now met the legal requirement. This report only covers our findings in relation to the requirement. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for VIP Care Solutions on our website at www.cqc.org.uk.

VIP Care Solutions is a domiciliary care agency providing personal care and support to people who live in their own homes. The agency is privately owned and this is the only registered location managed by the provider. At the time of our inspection four people were using the service.

The owner was also the registered manager and his wife was the only support worker. 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.

At our focused inspection on 20 March 2017, we found that the provider had not made all the necessary improvements to meet the requirement.

The provider failed to record observations of staff performance or audits of the service. Team meeting minutes were typed but not always accurate. There was no analysis or action plan for any records.

The provider had undertaken satisfaction surveys and was able to show us one response but could not locate two others.

Training was up to date.

The service did not have any incidents or accidents occur while they were supporting people but were aware of the need to record them. No notifications had been made to the Care Quality Commission as the service had not had any incidents requiring notification, but the provider said they were aware of their responsibility to make notifications to CQC as required.

VIP Care Solutions is a domiciliary care agency providing personal care and support to people who live in their own homes. The agency is privately owned and this is the only registered location run by the provider. At the time of our inspection four people were receiving a service, all of whom were paying for their own care. The agency provided care and support to older people.

The service was registered with the Care Quality Commission (CQC) on 18 October 2012, and last inspected on 12 November 2013, where we found that the provider was meeting all the standards we inspected.

The provider was also the registered manager. 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.

We were told that staff received the training and support they needed to care for people. However, there were no recent training certificates available so we could not be sure that staff had received training in the last three years.

The provider told us they carried out quality checks of the service. However they did not always keep records of these.

Records were disorganised and the provider was unable to locate a variety of records we requested, such as meeting minutes and records of spot checks.

The risks to people's wellbeing and safety had been assessed, and there were detailed plans in place for all the risks identified.

There were procedures for safeguarding adults and the staff were aware of these. The staff knew how to respond to any medical emergencies or significant changes in a person's wellbeing.

Feedback from people and their relatives was positive. Everyone said they had formed a good rapport and trusted their care worker.

People's needs were assessed by the provider prior to receiving a service and support plans were developed from the assessments. People had taken part in the planning of their care and received regular visits from the provider.

People we spoke with and their relatives said that they were happy with the level of care they were receiving from the service.

The provider and staff were aware of their responsibilities in line with the requirements of the Mental Capacity Act (MCA) 2005 and told us they had received training in this. People had consented to their care and support and we were told that nobody lacked capacity. Nobody was being deprived of their liberty unlawfully at the time of our inspection.

There were systems in place to ensure that people received their medicines safely and all the people who used the service were able to manage their own medicines.

There was only one care worker employed to deliver support to people who used the service. The provider was in the process of interviewing for another care worker to cover in the event of staff absence. Recruitment checks were in place to obtain information about new staff before they supported people unsupervised.

People's health and nutritional needs had been assessed, recorded and were being monitored.

There was a complaints procedure in place which the provider followed. People felt confident that if they raised a complaint, they would be listened to and their concerns addressed.

People and relatives told us that the provider and care worker were approachable and supportive. They encouraged an open and transparent culture within the service. People were supported to raise concerns and make suggestions about where improvements could be made.

We made a recommendation with regards to training of staff.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 which related to Good Governance. You can see what actions we told the provider to take at the back of the full version of this report.

Care plans detailed the support people required but did not contain individual details about people's likes, dislikes and preferences in relation to individual tasks and how these should be carried out.

The service had safeguarding policies and procedures in place to ensure that appropriate action was taken if there were concerns about a person's welfare.

The service was undertaking the required recruitment checks prior to staff working for the service to ensure they were suitable to work with vulnerable adults.

Quality assurance and monitoring systems were in the process of being developed to ensure areas for improvement were identified and addressed.