Sugarman Health and Wellbeing - Leeds

Updated 23 June 2022

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 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.

Service and service type

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

Registered Manager

This service is required to have a registered manager. At the time of our inspection there was a registered manager in post. 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.

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 4 May 2022 and ended on 17 May 2022. We visited the location’s office on 5 May 2022.

What we did before the inspection

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.

We reviewed information we held about the service including information about important events which the service is required to tell us about by law. We requested feedback from other stakeholders. These included the local authority safeguarding team, commissioning team, and Healthwatch Leeds. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.

During the inspection

We spoke with three people using the service and five relatives about their experience of the care provided. We gathered information from six members of staff including the registered manager.

We reviewed a range of records. This included two people’s care plans, risk assessments and associated information, and other records of care to follow up on specific issues. We also reviewed multiple medication records. We looked at three staff files in relation to recruitment, training and supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 23 June 2022

About the service

Sugarman Health and Wellbeing – Leeds is a domiciliary care agency providing personal care to adults and children with complex health conditions and learning disabilities, living in their own homes. During our inspection visit, the service was caring for 18 people.

People’s experience of using this service and what we found

People told us staff asked their consent before supporting with care tasks. People were supported to have maximum choice and control of their lives and we did not find evidence of care not being delivered in people's best interests, however, for people who were not able to consent to their care, mental capacity assessments and best interest decisions were not always decision specific or being completed. The policies and procedures in place were not being followed.

Medicines were mostly well managed, and people received their medicines as prescribed. Improvements were required in relation to how people’s ‘as and when’ required medicines were recorded and staff’s competency to administer medicines was not always checked in line with good practice guidance. We have made a recommendation in relation to management of medication.

Most people told us they felt safe with the care provided. Some people told us the lack of consistency in the staff team made them feel less safe; we discussed this with the registered manager, and they told us about their contingency and recruitment plans in place to address this issue.

Relevant risks to people's care were being assessed and planed for, and control measures put in place. However, some improvements were required in the recording of moving and handling risk assessments. The registered manager showed us the work they were already carrying out to improve these.

Staff felt well supported by management. There was a system in place to ensure staff were inducted and shadowed other experienced members of staff. Staff received varied training to meet the specific and complex clinical needs of people they were supporting; this included specialised training. However, we could not confirm all staff had received this training before they started supporting people. There were ongoing plans to make sure staff’s training were completed and up to date.

People were supported by staff who were caring and respected their dignity and privacy.

There was a complaints system in place. Most people and relatives told us they were confident that if they had any concerns, they could contact the registered manager and they would act on their concerns.

The service had a system in place to assess, monitor and improve the quality and safety of the services provided. However, some of the issues found at this inspection had not been previously identified in the provider’s own audits.

People, relatives and staff knew the manager and told us they were approachable. The registered manager told us about their plans to develop the service.

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 1 April 2020 and this is the first inspection.

The last rating for the service under the previous provider was good, published on 9 December 2017.

Why we inspected

This was a planned inspection.

We have found evidence that the provider needs to make improvement. Please see the safe and effective sections of this full report.

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

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified a breach in relation to consent at this inspection.

We made one recommendation for the provider to review good practice guidance in relation to the management of medicines.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.