Expertise Homecare (South East Coast)

Updated 26 November 2021

The inspection

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.

Inspection team

This inspection was conducted by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service a short period notice of the inspection as we needed to ensure that the provider or registered manager would be available in the office to support the inspection.

What we did before the inspection

Inspection activity started on 9 September 15 & 16 September 2021 which involved phone calls to service users, and care staff and correspondence to health and social care professionals. A planned visit to the office location on 29 September 2021 had to be rescheduled to 6 October 2021 due to unforeseen circumstances. Before visiting the Office, we sought feedback from the local authority and professionals who work with the service including Health watch. Health watch is an independent consumer champion that gathers and represents the views of the public about the health and social care services in England. We received feedback from 10 service users, two relatives, eight care staff and three Health and social care professionals.

We reviewed the information we had received about the service since its registration. We used the information the provider 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.

During the inspection-

We spoke with the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with the franchiser who supports and monitors the service.

We reviewed a range of records. This included four people’s care and medication records. We looked at four staff files in relation to recruitment staff supervision and observations. A variety of records relating to the management of the service including, quality audits, staff training records, complaints, accidents and incidents were reviewed.

Updated 26 November 2021

About the service

Expertise Homecare South East Coast is a domiciliary Agency providing personal care support to people in their own homes. At the time of inspection, they were providing support to 27 people of whom 26 were in receipt of the regulated activity personal care.

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

People spoke positively about how well they were treated by staff and praised the agency. We found there were some improvements that needed to be made to lessen risks to people using the service. Better communication from the office and being listened were areas cited by staff.

People received their agreed care calls but told us carers often arrived later than scheduled but were kept informed when this happened. The provider acknowledged the difficulties with recruiting staff at present and had taken action to combine routes and hand back to the local authority some harder to cover routes in order to manage and sustain care delivery.

Staff felt the agency was a good place to work, but some said they did not always feel supported or listened to. Staff supervision frequency had increased and team meetings had resumed, but care staff felt distanced from office staff feeling that communication and their concerns were being overlooked. The provider is taking action to address this, and this remains an area for improvement.

A quality assurance system was in place and audits were undertaken weekly, monthly and six monthly, to identify shortfalls, but a few audits needed to be conducted more robustly for example, recruitment. The franchiser also had oversight of the service and undertook annual compliance inspections.

People spoke positively about the agency, they said they felt safe and were happy with the care they received. They said staff always asked them before offering support. They were involved in their care plans which were detailed, and person centred. They were asked for feedback on a monthly basis. They were sent surveys and provided with a summary of survey outcomes and what the service was doing with the information people gave them to aid service development.

Staff were trained to administer medicines safely but we found some improvements were needed around use of ‘as required’ medicines and pain patches for individuals.

Staff received appropriate induction, and training to undertake their role.

Accidents and incidents were recorded and responded to well, to keep people and staff safe. People told us they knew how to complain and were satisfied with how their complaints were managed. Staff understood how to keep people safe and the provider had shown themselves to be proactive in identifying, and reporting abuse when they found it in their everyday support of service users.

People and relatives felt the management team and office staff were easy to talk with and felt happy and comfortable approaching them at any time.

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

This service was registered with us on 18/07/2019 and this is the first inspection.

Why we inspected

This was a planned first inspection of this service since it registered with CQC to check whether it was meeting the legal requirements and regulations associated with the Health and Social Care Act 2014. We looked at the overall quality of the service and provided a rating for this.

We have found evidence that the provider needs to make improvements. The provider has taken action to mitigate the identified risks. We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the Safe, Effective, and Well led sections of this full report.

Follow up

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.