5 February 2020
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.
The inspection was carried out by one inspector and an Expert by Experience who made telephone calls. 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
Superior Healthcare is a domiciliary care service registered to provide nursing and personal care to people in their own homes.
Inspection activity started on 19 November 2019 and ended on 21 November 2019. We visited the registered office on 19 November 2019.
The service had a manager registered with the Care Quality Commission who was also the nominated individual. This means that they are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was announced. We gave the service five days’ notice of the inspection. This was because the service supported some people with very complex health needs and we needed to gain people’s and relatives consent to being contacted for their feedback.
What we did before inspection
We reviewed information we had received about the service since the agency registered with the CQC. We sought feedback from the local authority and professionals who work with the agency. We used the information the registered manager sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with two people who used the service and five relatives about their experience of the care provided. We spoke with five members of staff including the registered manager, the operations manager, the assistant training manager and two care staff.
We reviewed a range of records. This included five people’s care plans, risk assessments, daily care records and medicines records. We looked at three staff files in relation to recruitment and staff support and supervision. We also saw a variety of records relating to the management of the agency, including a sample of audits, quality assurance surveys, accidents and policies and procedures.
5 February 2020
About the service
Superior Healthcare is a domiciliary care service registered to provide nursing and personal care to people in their own homes. The agency is registered to provide a service to the whole population, including babies, children and adults with complex heath needs including, physical disabilities, sensory impairments and care at the end of their life. At the time of our inspection 50 people were receiving personal care.
Not everyone using the agency received a regulated activity; the Care Quality Commission (CQC) only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
People’s experience of using this service and what we found
People and relatives spoke highly of the staff that had worked with them for several years providing consistency and continuity of care. Relatives told us that the nurses and care staff had built trusting relationships with their loved ones and felt like part of their family.
Staff were recruited depending on the skills and experience required to meet the person’s needs. Nurses and care staff were recruited safely. Staff felt supported in their role by the management team who were visible and approachable. Staff felt proud to work for the organisation and were valued in their role.
Staff were trained to meet people’s needs and registered nurses were supported to keep their registration with the Nursing and Midwifery Council (NMC). Nurses and care staff received continuous support and supervision from the management team.
People’s needs were assessed prior to receiving support from the agency. Care plans were person-centred and informed staff how the person wanted and needed to be supported. The care team worked closely with external health care professionals to promote people’s health.
People were supported to maintain their nutrition and hydration with staff preparing meals and nurses providing people with a specialist diet. Referrals were made to dieticians when concerns were identified about a persons’ eating or drinking.
Staff were caring, and knew people, their preferences, likes and dislikes well. Staff encouraged people to maintain their independence using aids to support this. Staff understood the importance of protecting people privacy whilst promoting their dignity.
Staff worked in partnership with the local hospice team to support people to have a dignified, pain-free death they and their families had chosen.
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’s, staff’s and relatives’ views and feedback were sought and acted on. There was an ethos of continuous improvement were any concerns were acted on to improve the service. Quality assurance questionnaires were sent out to gather further feedback alongside regular reviews. Systems were in place to enable people or relatives to make a complaint.
Systems were in place to monitor and improve the quality of the service people received. Lessons were learnt, and action was taken when any shortfalls were identified.
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 Good (published 24 February 2018). Since this rating was awarded the service has moved premises and re-registered. We have used the previous rating to inform our planning and decisions about the rating at this inspection.
Why we inspected
This was a planned inspection based on the previous rating and the timescale for unrated services.
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.