Supreme Care Services Limited

Supreme Care Services Limited is a domiciliary care agency providing personal care to people living in their own homes. At the time of our inspection 140 people were receiving personal care at home from this provider. The Care Quality Commission (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

People receiving a home care service and their relatives told us they were happy with the standard of care and support provided by Supreme Care Services Limited. A person said, “I am happy with the home care service I receive. My carers [staff] are always nice and polite, and come on time.” A relative added, “They [staff] treat my [family member] like a friend and we are 100 percent satisfied with the care he is getting. The carers [staff] never miss a visit or rush him, and always stay the agreed amount of time.”

At our last inspection, we found the provider had failed to ensure they notified us without delay about the occurrence of safeguarding incidents, appropriately maintained new staffs induction training records and communicated effectively with people outside of normal office hours.

At this inspection, we found enough improvements had been made. The provider had notified us without delay about all the safeguarding incidents that had happened in the last 6 months since their last inspection, appropriately maintained staffs induction training records and now effectively communicated with people who contacted them outside of normal office hours.

People continued to receive consistently good-quality and safe personal care from a small core group of staff who were familiar with their needs, preferences and daily routines. Staff knew how to prevent and manage risks people might face. The fitness and suitability of prospective new staff was thoroughly assessed and checked.

People continued to be protected against the risk of avoidable harm by staff who knew how to keep them safe. Medicines systems were well-organised, and people received their prescribed medicines as and when they should. People were confident any concerns they raised would be listened to and dealt with appropriately. Staff followed current best practice guidelines regarding the prevention and control of infection including, those associated with COVID-19. 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 supported this practice.

People were complimentary about the way the office-based managers and senior staff team ran the service, and how approachable they all were. Complaints, concerns, accidents, incidents, and safeguarding issues were appropriately reported, investigated, and recorded. The provider promoted an open and inclusive culture, which sought the views of people, their relatives, and staff. People had up to date, detailed, person-centred care plans in place, which were routinely assessed, monitored, and reviewed. The provider worked in close partnership with other health and social care professionals and agencies to plan and deliver people's packages of care at home.

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

Rating at last inspection and update

The last rating for this service was good overall (published 12 January 2023), but remained requires improvement for the well-led key question.

Why we inspected

We conducted an announced focused inspection of this service in December 2022 and made recommendations for the provider to improve. The provider completed an action plan after the last inspection to show what they would do and by when to improve on how they notified us about safeguarding incidents, kept new staffs induction training records and communicated with people outside of normal office hours.

We undertook this focused inspection to check they had followed their action plan and to confirm they had improved. This report only covers our findings in relation to the key questions safe and well-led, which contain those recommendations.

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 remained good and the well-led key question has changed from requires improvement to good.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Supreme Care Services Limited on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect. If we receive any concerning information, we may inspect sooner.

Supreme Care Services Limited is a domiciliary care agency providing personal care to older people in their own homes.

At the time of the inspection, there were 156 people using the service who were receiving help with personal care. The Care Quality Commission (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

Feedback from people and their relatives was generally positive about the care that was delivered by staff.

The provider had acted upon the breach we found at the last inspection in relation to managing risk.

However, we found there were some instances where the provider failed to notify CQC of some safeguarding concerns that had been raised and feedback received was that the response from the office was slower when the registered and service manager were not available and have made a recommendation to the provider about this. We have also made a recommendation in relation to staff recruitment files.

People using the service told us they felt safe in the presence of staff. We found there were enough staff employed to support people. The provider used an electronic call monitoring system in place to monitor timeliness of care visits and there had been an improvement in this area since the last inspection. There were safe recruitment procedures in place.

People received appropriate support with regards to their medicines and care workers wore the appropriate protective equipment, such as gloves and mask when supporting people.

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 supported this practice.

Feedback from people was that the service was generally good. The provider undertook unannounced spot checks, telephone monitoring and surveys to gather feedback about the service. There were a number of audits and quality checks to monitor the level of service, including medicines audits, auditing care worker visit times and carrying out mock CQC inspections.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 13 October 2021) and there was a breach of regulation in relation to safe care and treatment. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection enough improvement had been made in relation to the breach and the provider was no longer in breach of this regulation.

Why we inspected

This inspection was carried out to look at improvements against the breach found at the previous inspection. As a result, we undertook a focused inspection to review the key questions of safe and well-led only and also targeted to look at staffing in the key question effective and complaints management in the key question responsive so we could look at the training provision for staff and how the provider managed any complaints it received.

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 to good based on the findings of this inspection.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Supreme Care Services Limited on our website at www.cqc.org.uk

Supreme Care Services Limited is a domiciliary care agency. This service provides personal care to older people living in their own homes across Wandsworth and Merton. At the time of inspection, out of a total number of 171 people, 141 people were receiving 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 received positive feedback form people and their relatives about the service. They said the care workers were caring and treated them with respect and dignity. They all told us they felt safe in the presence of care workers who came to support them in their homes.

Despite the positive feedback, we found risk assessments were not always fully completed, which meant that there was risk that people could receive care that was not in line with their needs.

The provider had robust recruitment checks in place which helped to ensure staff were safe to work with people. We were assured that the provider had safe infection prevention and control procedures in place, including in relation to the management of COVID-19. People were supported to take their medicines and staff recorded this appropriately.

Care plans were comprehensive in scope and were reviewed on a regular basis. People told us they were involved in planning their care. The provider listened when complaints or concerns were raised and responded appropriately.

We received positive feedback about the management of the service from people and their relatives. The provider completed robust and regular quality checks which included care worker timekeeping, electronic call monitoring, unannounced spot checks, telephone monitoring and mock inspections. These provided assurance about how the service was running and where it could be improved. The views of people, relatives, staff and visiting professionals were sought and considered. The provider worked well with other agencies to ensure people received good care.

Rating at last inspection

The last rating for this service was good (published 12 July 2018).

Why we inspected

We received some safeguarding concerns. As a result, we undertook a focused inspection to review the key questions of Safe, Responsive and Well-led only.

We reviewed all the information we held about the service. No areas of concern were identified in the other Key Questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for the Key Questions of Effective and Caring were used in calculating the overall rating at this inspection.

Follow up

We will continue to monitor information we receive about the service. If we receive any concerning information we may inspect sooner.

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

This inspection was carried out on 5 June 2018 and was announced. 48 hours before the inspection we contacted the service to let them know that we will be coming to inspect them. We wanted to make sure that the registered manager would be available on the day of inspection.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

At the time of the inspection the service had a registered manager. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People had support to meet their needs safely. The service followed good practice to assess and monitor potential risks to people. Staff were thoroughly checked before they were employed by the service. Staff followed the service's processes to provide immediate support to people when incidents or accidents took place. Some people told us that staff were regularly late for their shifts but the management team had an action plan in place to address this issue.

Staff were supported to meet their role expectations as necessary. Where people required support to prepare their meals or attend to their health needs, staff had provided them with the assistance as required. Staff recently completed all the mandatory courses provided by the service and had their skills checked which ensured they were suitable for their role. However, we found that staff’s knowledge in relation to the Mental Capacity Act (2005) was limited and after discussing this with the management team we were told this would be addressed as necessary. Staff told us they reported any concerns to the management team, including if they noticed people not being able to make decisions for themselves.

People felt confident they received good quality services and that the staff team were caring and attentive to their well-being. Staff supported people to meet their individual needs and had information on what was important to people so they could meet people’s preferences. Staff had time to talk to people and put effort to have conversations with people. People felt dignified and respected which helped them to feel valued.

People’s care plans were easy to read and held all the necessary information for staff to adhere to ensure effective care for people. Robust assessments were carried out to provide staff with information on the support people required to stay safe always. Processes were in place for people to raise their concerns should they have any and actions were taken to resolve issues to people’s satisfaction.

People told us the management team responded to their needs quickly and appropriately when they approached them. A lot of effort was recently put to change the service’s culture to increase the staff team’s performance. Staff had support and motivation to perform their duties to a high standard. Systems were in place to monitor the quality of the service delivery and the registered manager followed processes to check on staff’s performance regularly. There were well established links with the local community which showed the service’s open mindedness and good practice.

Supreme Care Services is a domiciliary care provider which provides support and care to 265 people living in their own homes in the London Boroughs of Kingston and Wandsworth. People who use the service are mainly older adults living within the local community, some of whom have dementia. The service also supports some younger adults.

There was a registered manager employed at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The provider had arrangements to help protect people from the risk of abuse. People told us they felt safe because of the way staff cared for them. Plans to manage people's individual risks were in place, and staff took action to care for people in ways which promoted their safety. There were enough staff employed to care of people and speak with them so they did not become isolated. Staff reminded people to take their medicines appropriately.

All staff received induction training and subsequent refresher training. Staff told us access to training was good. They said they found training very helpful in doing their jobs effectively.

Our inspection of staff records indicated that staff received monthly supervisions and annual appraisals to make sure they were appropriately supported in their roles.

We found that people who used the service were supported to have a nutritious and balanced diet. Where necessary the provider ensured people were appropriately supported with their healthcare needs.

People gave us positive feedback about their regular care workers. People said they were treated with caring and kindness by them. They told us that where in the past they had experienced frequent changes in the staff who supported them, this had improved recently. In turn this had helped people develop much better relationships with staff who they said understood them better. People told us staff respected their privacy and dignity and encouraged them to express their views and be actively involved in their care and support.

People received care that was appropriate to meet their assessed needs. Their support plans were updated on a regular basis or when there was a change to their care needs.

The service had a complaints procedure. This enabled people to raise a complaint if the need arose. People were confident their complaints would be responded to appropriately.

We found there was a positive culture in the agency and good leadership. There were effective systems in place to continually monitor the quality of the service. People were asked for their opinions via feedback surveys. Action plans were developed where required to address any areas that needed attention. Records management was found to be good.

We considered our inspection findings to answer questions we always ask; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Was the service caring?

People who use the services were supported by kind and attentive care workers. Those people who we talked with said the care workers treated them well and respected their privacy. People said that they were very pleased with the care they received. One person said about their care worker, "She's a lovely girl, very caring and very dependable'. Another person told us, "I am very happy indeed, no complaints at all with the service they provide for me'. The relatives of people who we also spoke with said the care workers were caring, punctual and reliable. One person who we spoke with said, 'Overall it's a good service. It depends on the carers; the ones we have at the moment are good. They are kind and caring too'.

People who use the services told us they had discussed their care plans and that they were able to discuss relevant issues and make decisions about what they wanted to do.

Was the service responsive?

People who use the services were able to ask for changes in their care and support as their needs changed. Care plans were reviewed regularly and people told us that they felt well supported.

All the people who use the services we spoke with knew how to make a complaint. There was an appropriate complaints procedure in place. Those complaints that had been made since the last inspection had been resolved satisfactorily and the director indicated that they would be supportive of anyone who needed to complain.

Was the service safe?

People who use the services were treated with respect and dignity by the care workers. People told us they felt safe with the service they received. Safeguarding procedures were robust and care workers understood how to safeguard people being supported.

Recruitment practice was safe and thorough. The registered manager ensured that care workers were appropriately qualified to meet the care needs of people who used the services. This helped to ensure that people's needs were met.

Was the service effective?

People who use the services health and care needs were assessed together with them, and they were involved in their care and support planning. People told us that they had been involved in their care and support plans and that the plans reflected their needs. We inspected six people's care files. They included essential information about the person, needs and risk assessment information and service delivery or care plans.

Care workers received regular and appropriate training and supervision to ensure they were able to meet the specific needs of people using the service.

Is the service well-led?

The manager and the care co-ordinators carried out regular checks to assess and monitor the quality of services provided and took appropriate action to address any issues or concerns raised about service quality.

The views of people who use the services, their representatives and care workers were listened to by the managers. Care workers told us they were clear about their roles and responsibilities. They had a good understanding of the ethos of the agency. This helped to ensure that people received a good quality service.

The manager told us that home's policy to do with staff supervision had been revised since the last inspection and new practice implemented. We were told by the manager that staff now received regular supervision quarterly. A care co-ordinator told us that staff received improved supervision and that people who used the service have remarked on the improvements. We saw evidence that demonstrated that staff had been on appropriate and relevant training since the last inspection.

We spoke with the manager about the agency's complaints process and we saw that there was an effective complaints system available. Complaints had been analysed to identify any emerging trends so that appropriate action could be taken and comments and complaints that people had made were responded to appropriately.

The manager and the care co-ordinators we spoke with told us that each service user had a copy of their care plan in their home. All the people we spoke with said that they had a care plan and that they were able to express their wishes and preferences to do with the care and support they received. One person said, 'I have a care plan and they asked me how I wanted the support right at the beginning of the care'.

People told us that they felt safe with their care workers and that they wore their staff identity badges and a uniform. This has helped protect people from potential abuse as they know that the people who visit them are Supreme Care staff.

Staff supervision and performance appraisal had not been carried out according to the agencies policy and procedures.

People knew how to make a complaint. Where they had to complain, improvements had been made. One person who we spoke with said, 'I had to complain because things were not being done and we didn't have a care plan. Supreme dealt with the complaint well and things have improved a lot since then'.

All of the people said that they felt safe with their care workers. However some people said that their care workers did not always wear their uniforms or identity badges.

People said that their care workers were kind and courteous and always respectful. However most people said that they were often late and that they did not get a call from the office to let them know that their care worker was going to be late.

All the people we spoke to knew how to make a complaint but they said that at the time they did not need to do so.