We carried out a review of the data available to us about Specialist Care Services on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Specialist Care Services, you can give feedback on this service.
Specialist Care Services Limited is a domiciliary care agency. It provides personal care to mostly older people living in their own homes in the London Borough of Hillingdon. It also supports some adults who are living with dementia and adults who have physical or learning disabilities. At the time of our inspection the service was providing care and support to 141 people.
Not everyone using the service receives personal care. CQC only inspects the service being received by people provided with ‘personal care’, that is, help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.
People’s experience of using this service and what we found.
People told us they felt safe when receiving care. Care workers were assessed as competent to administer people’s medicines. The provider had processes in place for the recording and investigation of incidents and accidents, safeguarding and complaints.
Risk management plans had been developed which provided care workers with guidance on how to minimise risks in relation to health and wellbeing for people using the service.
The provider had safe recruitment practices in place. There were enough care workers allocated to each visit to provide the support people needed.
Care plans described the care and support a person required and how they wanted it to be provided.
People using the service were supported to maintain links with their family and community to reduce the risk of social isolation.
The provider had a complaints process in place and people told us they knew what to do if they wished to raise any concerns.
There was a range of quality assurance processes in place to identify if any actions were required to improve the service. People using the service and staff felt the service was well-led.
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 improvements (published 31 May 2019) and there were three breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an announced comprehensive inspection of this service on 26 and 27 March 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve person centred care, safe care and treatment and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. 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 Specialist Care Services on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Specialist Care Services Limited is a domiciliary care agency. It provides personal care to mostly older people living in their own homes in the London Borough of Hillingdon. It also supports some adults who are living with dementia and adults who have physical or learning disabilities. At the time of our inspection the service was providing care and support to 290 people.
Not everyone using the service name receives personal care. CQC only inspects the service being received by people provided with ‘personal care’,that is, help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.
People’s experience of using this service:
Staff were caring, treated people with respect and promoted people’s dignity and privacy.
People told us that they felt safe. However, the provider had not always assessed the risks to people’s health and well-being or done all that was reasonably practicable to mitigate those risks.
There were processes to ensure people received support with their medicines, but the provider did not always ensure the safe and proper management of medicines. The provider had not sufficiently assessed staff to ensure they were competent to give the medicines support being asked of them.
People’s care and risk management plans set out the care they required, but these plans did not always provide personalised information about people and their preferences for how they liked to be supported.
There were systems in place to monitor the quality of the service and identify when improvements were required. These were not sufficiently robust to have identified the issues we found in relation to the management of risks to individuals’ health and wellbeing, medicines support competency, and care planning.
There were enough staff deployed to support people and staff usually arrived on time at people’s homes.
Staff received induction, training and supervision. There was a clear management structure and staff felt supported in their roles.
The provider sought feedback from people, relatives and staff and used this to develop the service.
People and staff were confident that could raise any concerns they had with the registered manager.
Staff and the registered manager regularly provided extra support and assistance to people when this was not part of people’s contracted care arrangements.
We discussed the areas of concern with the registered manager during the inspection and they started to put in place systems to make the required improvements.
We identified three breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 relating to safe care and treatment, person-centred care, and good governance. Please see the 'action we have told the provider to take' section towards the end of the report.
Rating at last inspection:
We rated the service good at our last comprehensive inspection. We published our last report on 29 September 2016.
Why we inspected:
This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.
Follow up:
We have asked the provider to send us an action plan telling us what steps they are to take to
make the improvements needed. We will continue to monitor intelligence we receive about the service and we will return to re-inspect in line with our inspection timescales for services rated requires improvement. We may inspect sooner if we receive any concerning information regarding the safety and quality of the care being provided.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
Specialist Care Services is a domiciliary care agency that provides personal care to around 350 people in their own homes. At the time of the inspection the service was referred to as The Princes Lodge on the Care Quality Commission website but this has been amended to Specialist Care Services since the inspection.
We previously inspected Specialist Care Services on 4 October 2013 and the provider had met all the regulations that were inspected.
At the time of the inspection there was a registered manager in place. 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.
People told us they felt safe when they received support and the provider had policies and procedures in place to deal with any concerns that were raised about the care provided.
The provider had processes in place for the recording and investigation of incidents and accidents.
The provider had an effective recruitment process in place but some references did not provide appropriate information on the applicant, however, this was being reviewed by the registered manager.
There was a policy and procedure in place for the administration of medicines.
Care workers had received training identified by the provider as mandatory to ensure they were providing appropriate and effective care for people using the service. Also care workers had regular supervision with their manager and received an annual appraisal.
The provider had policies, procedures and training in relation to the Mental Capacity Act 2005 and care workers were aware of the importance of supporting people to make choices.
People we spoke with felt the care workers were caring and treated them with dignity and respect while providing care. Care plans identified the person’s cultural and religious needs.
Detailed assessments of the person’s needs were carried out before the person started to receive care in their own home. Each person had a care plan in place which described their support needs. Care workers completed a record of the care and support provided during each visit.
The provider had a complaints process in place and people knew what to do if they wished to raise any concerns.
The provider had systems in place to monitor the quality of the care provided and these provided appropriate information to identify issues with the quality of the service.
The Princes Lodge is a domiciliary care agency that provides personal care to around 350 people in their own homes.
We previously inspected The Princes Lodge on 4 October 2013 and the provider had met all the regulations that were inspected.
At the time of the inspection there was a registered manager in place. 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.
People told us they felt safe when they received support and the provider had policies and procedures in place to deal with any concerns that were raised about the care provided.
The provider had processes in place for the recording and investigation of incidents and accidents.
The provider had an effective recruitment process in place but some references did not provide appropriate information on the applicant, however, this was being reviewed by the registered manager.
There was a policy and procedure in place for the administration of medicines.
Care workers had received training identified by the provider as mandatory to ensure they were providing appropriate and effective care for people using the service. Also care workers had regular supervision with their manager and received an annual appraisal.
The provider had policies, procedures and training in relation to the Mental Capacity Act 2005 and care workers were aware of the importance of supporting people to make choices.
People we spoke with felt the care workers were caring and treated them with dignity and respect while providing care. Care plans identified the person’s cultural and religious needs.
Detailed assessments of the person’s needs were carried out before the person started to receive care in their own home. Each person had a care plan in place which described their support needs. Care workers completed a record of the care and support provided during each visit.
The provider had a complaints process in place and people knew what to do if they wished to raise any concerns.
The provider had systems in place to monitor the quality of the care provided and these provided appropriate information to identify issues with the quality of the service.
People told us that they had been involved in decisions relating to their care and staff treated them with dignity and respect. One person said "my care worker is always very polite and courteous." The majority of people we spoke with said their care workers were punctual and stayed the agreed length of the visit. However some people expressed concerns that their care worker had on occasions not arrived and they did not always get the same care worker every visit.
People were protected from abuse, staff had completed training in safeguarding and were aware of the steps to take if they had any suspicions of abuse. Staff received appropriate professional development to ensure they could meet the needs of people using the service.
There were arrangements in place to get people's views of the service through quarterly satisfaction surveys. The results had been analysed and action taken to address any issues. A complaints procedure was in place and complaints had been investigated and resolved where possible.
We viewed summarised feedback from a user satisfaction survey which showed that most people using the agency were happy with the support and care they received from staff.
People told us that they felt safe with staff and were able to raise any concerns if there was any need to do so