Support 4 u healthcare

Updated 20 January 2023

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 Health and Social Care Act 2008.

Inspection team

This inspection was carried out by one inspector.

Service and service type

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

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 48 hours' notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 29 November 2022 and ended on 12 December 2022. We visited the location’s office on both dates.

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We used information gathered as part of monitoring activity that took place on 24 October 2022 to help plan the inspection and inform our judgements. We reviewed information we had received about the service since they registered with the CQC. We sought feedback from the local authority who work with the service. We used all this information to plan our inspection.

During the inspection

We used technology such as telephone calls to enable us to engage with people using the service, relatives of people and staff, and electronic file sharing to enable us to review some of the documentation requested. We also reviewed documents and spoke to some staff during our visits to the office.

We spoke with two people who used the service and three relatives of people who used the service about their experience of the care provided. We received feedback from the local authority.

We spoke with six members of staff including the registered manager, operations manager, a care coordinator and three care staff.

We reviewed a range of records using electronic file sharing and during our site visit. This included four people's care records and we looked at medication and mental capacity assessment records. We looked at four staff files in relation to recruitment, and copies of right to work permits during our office visit.

We also looked at staffs training, spot checks and staff supervision. A variety of records relating to the management of the service were also reviewed. This included staff training records, incident and accident records, complaints, quality assurance processes and policies.

After the inspection

We spoke with the registered manager to establish their understanding of notifying the CQC of incidents and safeguarding they were required to do so.

Updated 20 January 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right support, right care, right culture, as it is registered as a specialist service for this population group.

About the service

Support 4 u healthcare is a domiciliary care service that provides personal care and support to people living in their own homes. The service provided personal care and support to 11 adults at the time of the inspection.

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

Quality audits were not carried out to monitor the quality of the service provided. Improvements were found to be required in relation to the accuracy of people’s care records and gaps in recruitment checks. As such, the governance monitoring system in place had not identified all areas needing improvement.

Potential new staff to the service had a series of checks carried out to ensure they were suitable to work with the people they supported. However, we found areas for improvement were needed to ensure these checks were robust.

Staff had access to information in peoples' care plans and risk assessments that helped guide them to care and support people effectively. However, these records could be more detailed to help guide staff.

We have made a recommendation about improving the level of detail within people’s care records and risk assessments to guide staff on people’s health conditions and known risks.

Staff were trained to administer people’s prescribed medicines safely. However, information to guide staff on ‘as required’ medicines such as pain relief could be more detailed.

We have recommended that the provider and registered manager follows medicines best practice guidance.

Whilst there was no one currently using the service with a learning disability or autism. The registered manager had not read the CQC guidance for supporting people with a learning disability called ‘Right support, right care, right culture’. Their registration with the CQC had stated they may support people with a learning disability and or autism in the future.

People, and their relatives had positive opinions on the communication of the office staff and management team. They told us the various ways staff requested feedback on the service. This included verbally during staff spot checks and via a survey. Staff were trained and had some spot checks undertaken to check they were working in line with their training. However, catheter care spot checks had not been completed to ensure staff followed this training. Staff were encouraged to discuss and review their performance through supervision and team meetings.

Staff were kind and respectful towards people. There were enough knowledgeable and trained staff to meet people's care and support needs. They understood how to keep people safe from poor care and harm. Staff told us they would whistle-blow any concerns they may have to their registered manager or the CQC. Where people wanted to discuss their end of life wishes this information would be recorded to guide staff.

Staff told us they were trained in infection prevention and control and followed good practice guidance in relation to this. Systems were in place to learn lessons when an incident, accident or near miss occurred or there was a risk of this.

Staff encouraged people to drink and eat plenty. People were encouraged to make their own choices and these choices were respected. Staff helped promote and maintain people's privacy and dignity. They also encouraged people to be as independent as possible and with the support from staff, people were able to remain in their own homes. Staff also encouraged people and their relatives, where appropriate, to be involved in discussions around their support and care needs.

The registered manager worked with external health and social care professionals. This would help people to receive joined up care and support. There was a process in place to investigate and resolve complaints where possible. Actions were taken as a result of learning to try to reduce the risk of recurrence.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 09 October 2019 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service. This inspection also was based on the service being unrated since it registered with the CQC.

Enforcement

We have identified breaches in relation to recruitment and governance. Please see the action we have told the provider to take at the end of this report.

Recommendations

We have made some recommendations for the provider around medicines and people’s care plans and risk assessments.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of recruitment, quality monitoring and CQC notifications. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.