Concept Care Solutions Ltd

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

People told us people they were happy with the care and support they received because they felt safe and their needs were met by kind and caring staff.

At the last inspection we found there were breaches of the regulations. Safeguarding incidents and allegations of abuse had not always been properly managed or reported as necessary to the Commission. Robust governance was not in place; audits and checks had been ineffective in driving the necessary improvements, and staffing levels were not always safe. At this inspection Improvements had been made in all these areas.

People had access to healthcare services and were involved in decisions about their care. Partnerships with other agencies and health professionals enabled effective outcomes for people. Staff supported people to take medicines safely.

Risks to people were assessed and regularly reviewed. Staff understood the actions needed to minimise the risk of avoidable harm including the prevention of infection. Staff had completed safeguarding training and understood their role in identifying and reporting any concerns of potential abuse or poor

practice. There were improved systems in place to record or track incidents and allegations of abuse.

People and staff praised the managers of the service and agreed that they were approachable, knowledgeable, fair and did their job well. The staff team worked well together and supported the registered manager.

The staff team was committed to providing a high-quality service. They had undertaken training so that they were skilled and knowledgeable to effectively meet people’s needs. Staff understood their responsibilities to report any concerns.

Staff encouraged people to be as independent as possible and respected people’s privacy and dignity.

People were given choices about the way in which they were cared for. Staff listened to them and knew their needs well. Care plans contained information about each person’s individual support needs and preferences in relation to their care and we found evidence of good outcomes for people. When people did not have the capacity to make their own decisions, staff maximised their involvement and made decisions in their best interests, in accordance with legislation.

Recruitment practices were safe and relevant checks had been completed before staff worked at the service.

People told us that staff were able to meet their needs and were respectful of their individual preferences. Relatives told us staff who supported their loved ones were kind and caring.

People confirmed the service did not miss any care calls and that staff were usually on time.

People received care and support from a small group of staff, which provided consistency.

The managers of the service actively sought the views of people and their relatives about the running of the service and they dealt promptly with any concerns that people raised.

The provider had systems in place to monitor and improve the quality and safety of the service provided.

More information is in the full report.

Rating at last inspection

The last rating for the service was requires improvement (published 3 December 2019).

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

We undertook this focused inspection to check they had followed their action plan and to confirm they now

met legal requirements. This report only covers our findings in relation to the Key Questions, Safe, Responsive, Caring and Well-Led which contain those requirements. At this inspection we found improvements had been made and the provider was no longer in breach of regulations. The ratings from the previous comprehensive inspection for those Key Questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

Follow up

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

Concept Care Solutions Ltd (Edgware) is a domiciliary care agency providing personal care to 101 people at the time of the inspection. The service supported older people, children and young adults with physical and learning disabilities, mental health needs, Autism and Asperger’s.

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

We identified shortfalls in the leadership and management of the service which impacted on the quality of care people received. The registered manager failed to adhere to registration regulatory requirements. Robust governance was not in place; audits and checks had been ineffective in driving the necessary improvements.

The service was not safe. Systems to identify, monitor, record and report matters which could be a safeguarding issue were not followed properly. Safeguarding incidents and allegations of abuse had not always been properly managed or reported as necessary to the Commission which meant people were at risk of a reoccurrence.

People supported by regular, experienced care workers experienced better outcomes than those who were not. People told us they were not always informed of who was scheduled to attend their care calls and were not informed when carers were running late.

The provider did not have robust systems in place to monitor the quality of the service provided. We found up to date records were not kept regarding improvements made to the service. The service did not record how they learned from accidents and incidents and did not notify the Care Quality Commission of such events, as they are required to do.

Not all people knew how to make a complaint and people did not always receive a response from the service when they raised complaints. We have made a recommendation about this.

Most people told us their privacy and dignity were respected and their care workers were caring and kind.

People were supported, when required, to receive their medicines regularly and staff completed the medicine administration records. Staff were aware of how to reduce the risk and spread of infection.

Staff obtained people's consent before supporting them. People were supported where required to eat and drink sufficient amounts to remain healthy and were supported to access 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.

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 04 January 2017). Since this rating was awarded the registered provider of the service has moved premises and changed its name from Concept Care Solutions - 1st Floor Middlesex House to Concept Care Solutions Ltd (Edgware). We have used the previous rating to inform our planning and decisions about the rating at this inspection.

Why we inspected

The inspection was prompted in part due to information of concerns received from the local authority commissioning team. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the Safe, Caring, Responsive and Well Led sections of this report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to safeguarding, good governance and staffing. Please see the action we have told the provider to take at the end of this report.

Since the last inspection the provider had failed to notify CQC of significant events occurring at the service. This was a breach of the Care Quality Commission (Registration) Regulations 2009, Notification of other incidents. Full information about CQC’s regulatory response to this is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.