Background to this inspection
Updated
2 August 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
The inspection was carried out by 2 inspectors and 1 Expert by Experience who made calls to people using the service. 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 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
This inspection was announced. We gave the service a short notice period of the inspection. This was because it is a small service and we needed to be sure that the registered manager would be in the office to support the inspection.
Inspection activity started on 7 June 2023 and ended on 20 June 2023. We visited the location’s office on 15 June 2023.
What we did before the inspection
We reviewed information we had received about the service since the service was registered with us. We sought feedback from the local authority and professionals who work with the service.
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.
During the inspection
During the inspection we spoke with 6 people using the service and 7 family members.
We spoke with 11 members of staff, including 6 care workers, the care coordinator, the quality coach, the care manager, the registered manager and the care consultant. We also received email feedback from 3 additional members of staff.
We reviewed a range of records. This included 8 people's care and support plans, as well as people's medicines records where they received support with this task.
We looked at 12 staff files in relation to recruitment, training and supervision. We reviewed a variety of records relating to management of the service including policies and procedures, accident and incident records, compliments and complaints and audits of the service. We received feedback from 5 professionals.
Updated
2 August 2023
About the service
Quality and Compassion Ltd is a domiciliary care agency providing the regulated activity personal care. The service provides support to people living in their own home. At the time of our inspection there were 25 people using the service. All of the people using the service were receiving the regulated activity personal care.
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.
People’s experience of using this service and what we found
Right Support:
Whilst staff supported people to be involved in day to day decisions about their care, people were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
Risks to people were not mitigated to ensure they got the right support and safe medicine practice was not promoted. Recruitment practices were not always safe and further increased risks to people.
People were supported by a consistent staff team with no missed calls reported and systems were in place to inform people if staff were running late for calls. The registered manager worked closely with professionals involved in people’s care to ensure the required support and intervention was provided.
Right Care:
Staff were not suitably trained and competent for the roles they were involved in. Therefore, the registered manager had not assured themselves that staff had the skills, training and competencies to ensure people got the right care.
Person centred care was promoted and people were supported to community events which promoted their well-being. People’s privacy, dignity and independence were promoted with people describing staff as “kind and caring.”
Right Culture:
The service was not effectively audited and monitored, to promote positive outcomes for people. Records were not suitably maintained, accurate and accessible which placed people at risk.
The registered manager was actively involved in the running of the service. They had positive relationships with people who used the service, relatives and staff. They had empowered people with complex care packages to be cared for in their home.
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 28 September 2020 and this is the first inspection. 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. Please see the safe, effective, and well-led sections of this full report.
Enforcement and Recommendations
We have identified breaches in relation to risk management, medicine management, recruitment of staff, consent to care, staff training, auditing, and record management at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
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.