13 January 2023
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.
The inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
One inspector visited the office and reviewed records; visits were made to three supported living services and inspectors spoke to staff and the people using the service. The expert by experience made telephone calls to people and relatives about their experiences of care.
Service and service type
The service provides care and support to people living in twelve supported living settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.
At the time of our inspection there was no registered manager in post.
Notice of inspection
This inspection was announced, and we gave the service 24 hours’ notice of the inspection as people are often out and we wanted to be sure there would be people at home to speak with us and that they consented to this. Inspection activity started on 9 November 2022 when we visited the location’s office. We concluded the inspection on 24 November 2022 when we provided feedback.
What we did before the inspection
We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We also sought feedback from the Local Authority. We used all this information to plan our inspection.
During the inspection
Some people we met during the inspection had complex needs and were not able to tell us about their experiences. We therefore used our observation of care and other evidence to help form our judgements.
We spoke with two people who used the service and eight relatives. We spoke to nine staff as well as two company directors and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We looked at selected care plans and risk assessments, medication and staffing rotas. We reviewed staff recruitment and training records as well as quality assurance systems.
13 January 2023
About the service
Vital Healthcare Services Limited is a supported living service providing personal care to people who live in their own homes across Suffolk.
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. At the time of the inspection, a total of eight people were using the service and receiving personal care.
People’s experience of using this service and what we found
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.
The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.
• People told us that the support from staff was kind and caring and we observed staff offering people choices about daily living.
• People were supported to participate in a range of activities and to access the community facilities.
• Staff were not always clear about restrictive practices and the use of restraint, therefore there was a risk that people may not receive the right support. The provider told us that they were providing breakaway training to staff.
• There were gaps in risk assessments in key areas such as health plans which placed people at risk of not receiving the right support when they needed it.
• People were supported to maintain relationships with friends and family, and we saw that there were a variety of arrangements in place reflecting people’s individuality.
• People were supported by a core team of staff however there was a high staff turnover and staff changes impacted on people. We have made a recommendation regarding training.
• Staff were clear about how people communicated and had access to tools to support this.
• Risks to people’s safety were not always identified and effectively managed.
• Incident reports were not always fully completed so it was not always clear what actions staff took to protect people in the future.
• Efforts were being made to promote a caring culture and the service implemented value based recruitment to ensure that the staff they appointed had the right values.
• There were quality assurance systems in place, but they were not robust and had not independently identified some of the shortfalls that we had found to ensure people consistently received a good service.
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 the service was good (published 2 August 2021.)
Why we inspected
This inspection was prompted by a review of the information we held about this service. We have found evidence that the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full report.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Vital Healthcare on our website at www.cqc.org.uk. We have found evidence that the provider needs to make improvements. Please see the Safe, Effective and Well Led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.