Background to this inspection
Updated
3 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 1 inspector and 1 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 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 21 June 2023 and ended 28 June 2023. We visited the location's office on 28 June 2023.
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 reviewed information we had received about the service. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection.
During the inspection
We spoke with 5 people who used the service and 8 relatives. We spoke with a social worker with regards to 1 person who used the service. We also spoke with 4 care staff and the registered manager. We looked at the care records for 7 people. We checked the care people received matched the information in their records. We looked at 3 staff files with regards to staff recruitment. We looked at records relating to the management of the service, including audits carried out within the service.
Updated
3 August 2023
About the service
Everready Health and Social Care Solutions provides personal care within people’s own houses and flats. At the time of our inspection 15 people, were using the service. 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
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.
Right Support: 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 support this practice.
Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life.
Right Care: People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.
Right Culture: Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing.
The provider’s governance was ineffective to identify the shortfalls found during this inspection.
People could not be assured staff would have the appropriate skills to support them with their prescribed medicines. This is because there was lack of evidence medicines competency assessments were carried out by a competent person.
Where a needs assessment was not carried out prior to people receiving a service, this could compromise the care and support they received. There was no emphasis focused on equality and diversity during the assessment and care planning and this meant people needs may not be met the way they wanted. Relevant official documents were not accessible, and this could compromise people’s expressed wishes. We found where a person was receiving end of life care, staff did not have access to an end-of-life care plan, to ensure the person’s wishes would be met. We have recommended that this should be put in place.
People could not be confident their communication needs would be met due to the lack of understanding of the Accessible Information Standards.
People were cared for by sufficient numbers of staff who had been recruited safely.
Risk assessments were in place to promote people’s independence whilst ensuring their safety. Staff were skilled and knowledgeable in reducing the risk of people contracting avoidable infections.
People were protected from potential abuse because staff knew how to recognise abuse and how to safeguard them.
People could be confident they would be supported to eat and drink sufficient amounts and where needed received assistance to access a speech and language therapist or dietician for additional support. People were supported to access relevant healthcare services to ensure their needs were met.
People were supported by staff who had received training and who were supported in their role by the registered manager.
Routine welfare calls were made to people to obtain their views in relation to the service they receive. Staff felt supported by the registered manager who worked with other agencies to ensure people’s needs were met.
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.
Why we inspected
This is a newly registered service. Hence, we looked at all 5 key questions, Safe, Effective, Caring, Responsive and Well-Led.
The overall rating for the service is requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see Safe, Effective, Responsive and Well-Led sections of this report.
Enforcement
We have identified a breach in relation to the provider's governance. There were no monitoring systems to ensure calls were not missed. Medicines competency assessments were not carried out by a skilled competent person. Systems and practices did not ensure official documents were in place to ensure people’s expressed wishes would be adhered to. Care records made no reference to equality and diversity. Needs assessments were not always carried out prior to people receiving a service.
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.