Archived: Verrolyne Services Limited

Verrolyne Services Limited is a domiciliary care agency located in the London Borough of Havering. It is registered to provide personal care to people in their own homes. It is registered to support adults aged 18 years and over, and children aged up to 17 years, all of whom may have mental health needs, learning disabilities, physical disabilities and sensory impairments. 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. At the time of the inspection, 53 people were using the service who received 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

Since our last inspection in April 2023, there had been a change in ownership of the provider which caused some disruption to the service. The service was not always safe because risks to people were not assessed and managed thoroughly. Systems and processes to protect people from the risk of abuse were in place but staff did not have up to date training in this area. We did not find evidence people had been harmed. However, there were concerns people were at risk of neglect because people experienced missed visits when the service failed to provide the care people had expected. Staff followed infection control procedures and people were protected from the risk of infections.

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 and relatives told us staff were respectful and caring.

Right Care

Care to people was not always person-centred. Care plans and assessments of people’s needs lacked information for staff to meet people's needs safely. Not all staff had received up to date refresher training at the time of our inspection. There was a risk of staff shortages. People told us they had mixed experiences and feelings about staff punctuality and reliability. This was due to delays to their care and changes to their regular staff who attended their home. People’s dignity, privacy and human rights were respected.

Right Culture

Leaders and the culture they created did not always support the delivery of high-quality care. Quality assurance systems were not robust to identify some of the shortfalls in the service. People and relatives were contacted for their feedback about the service. The provider did not notify us of changes to the service in a timely way. The provider acknowledged that further work was needed to make improvements to the service. Staff told us they were supported by the new management team and received supervision to discuss their performance.

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

Rating at last inspection

The last rating for the service was Good, (published on 23 May 2023).

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

Why we inspected

The inspection was prompted in part due to concerns received following a change in ownership of the provider since our inspection in April 2023. We received concerns about staff recruitment, staff training, the coordination of care and the management of the service. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment of people, staff training, safeguarding people from the risk of abuse and good governance at this inspection. We have made recommendations about how the service records staff support with people's medicines and completes initial assessments of people's needs.

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

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.

Verrolyne Services Limited is a domiciliary care agency located in the London Borough of Havering. It is registered to provide personal care to people in their own homes. The service can support people who may have dementia, mental health needs or physical disabilities. At the time of the inspection, 65 people were using the service.

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

The provider had made improvements to the service following our last inspection. People told us they felt safe using the service.

Risk assessments for people were in place to protect them from coming to harm. Risks such as those related to people's health conditions and mobility were monitored so staff could support them safely.

People were supported with their medicines if required. However, we have made a recommendation for the provider to follow best practice guidance on recording medicines.

Safeguarding processes were in place to protect people from the risk of abuse. The provider carried out background checks to make sure staff they recruited were of suitable character to support people. People told us staff were punctual and completed their tasks according to their needs.

There was a procedure for reporting incidents and accidents in the service and learning lessons from them to prevent re-occurrence. Infection control procedures were in place to protect people and staff from the risk of infections. Staff had received training to ensure they had the necessary skills and qualifications to provide support to people. Staff told us they were supported by the management team to perform in their roles.

Assessments of people’s needs were carried out before they started using the service. People's consent was sought when care was provided. 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. Staff supported people to maintain their independence. Details of health professionals involved in people’s care were included in care plans. People’s food and drink preferences were assessed to ensure they could be supported to maintain a balanced diet.

People told us staff were respectful and caring towards their family members. Their privacy and dignity were respected. People’s human rights and equality and diversity characteristics were respected. People and relatives were able to express their views about the care provided.

Care plans recorded people’s needs and preferences and people received person-centred care. People’s communication needs were met by staff. There was a procedure for complaints to be acknowledged, investigated and responded to. People and relatives told us the service was well managed.

Feedback about the service from people and relatives was received and acted upon. There were quality assurance systems in place for the provider to continuously improve the service. A contingency plan was in place should events occur that stop the service running safely and properly.

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

Rating at last inspection

The last rating for the service was Requires Improvement, (published on 5 September 2022) and there were several breaches of regulations.

We issued warning notices to the provider for breaches of regulation 12 (Safe care and treatment), regulation 9 (Person-centred care), regulation 18 (Staffing) and regulation 17 (Good governance). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

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

Why we inspected

We carried out an announced comprehensive inspection of this service on 28 June 2022 and 1 July 2022. 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 safe care and treatment, person-centred care, staffing systems and good governance of the service.

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

The overall rating for the service has changed from Requires Improvement to Good based on the findings of this inspection.

Enforcement and recommendations

We have made a recommendation for the provider to follow best practice guidance on recording medicines after reminding people to take them, because their policy was not clear on this.

Follow up

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

Verrolyne Services is a domiciliary care agency located in the London Borough of Havering. It is registered to provide personal care to people in their own homes. At the time of the inspection, approximately 151 people were receiving support. CQC only inspects domiciliary care agencies where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do receive personal care, we also consider any wider social care provided.

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

People were not always supported in a way that was safe. Risks to people such as those with specific health conditions such as diabetes, panic attacks and breathing difficulties were not always assessed and managed. This meant staff did not have the necessary guidance on how to support people with these conditions, should they experience symptoms.

Staff were monitored to check they had arrived for their visits to people and completed their tasks. However, we noted instances where staff did not always complete ‘double up’ visits together as planned. Some staff, people and relatives did not feel there was enough travel time and we found some calls were arranged too close together. People told us staff did not always attend calls at planned times. We were not assured staff were being deployed in the community to carry out their roles effectively.

We did not find evidence people had been harmed but there were concerns of neglect and that people were not sufficiently protected from abuse. We have made a recommendation for the provider to implement more robust safeguarding training for staff.

Assessments of people’s needs were sometimes not suitable nor carried out effectively. People did not always receive person-centred care. Care plans were sometimes inaccurate and inconsistent, which meant people’s needs may not be met and understood by staff. Care plans lacked information for staff to meet people's needs safely.

Incidents and accidents were reviewed and analysed to prevent re-occurrence. Staff followed infection control procedures and people were protected from the risk of infections such as COVID-19. Staff were safely recruited and received training and an induction. Staff told us they were supported by the registered manager and received supervision to discuss their performance. Most staff told us they could raise any concerns they had, although some staff told us they did not want to raise their concerns. The provider had in place a whistleblowing policy and told us staff could raise their concerns during supervision meetings.

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 and relatives told us staff were respectful and caring and supported them to maintain their independence. Staff respected people's privacy and people's needs were met in relation to equality and diversity issues. We have made a recommendation for the provider about describing people's needs in a more dignified way.

The provider had systems to make improvements to their training processes, but more work was needed to ensure quality assurance systems were robust and effective.

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

Rating at last inspection

The last rating for the service was Good, report published on 26 March 2019.

Why we inspected

The inspection was prompted in part due to concerns and complaints received about the reliability and safety of the service, the punctuality of staff and the way the service was managed.

A decision was made for us to inspect and examine those risks. We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well-led sections of this report.

The provider has begun to take steps to improve the service. During our inspection, the provider shared their service improvement plan for our assurances, and they had started to make improvements to the care and support provided to people. However, the concerns we identified meant people could be at continued risk of unsafe care.

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relations to safe care and treatment, good governance, staffing and person-centred care. We also made some additional recommendations.

Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.

Verrolyne Services Limited provides personal care to people in their own homes. The service is based in Romford, Essex and 99 people were using the service at the time of our inspection.

People’s experience of using this service:

¿People and their relatives were happy with the service they received. They and their relatives provided their consent to care. Most people told us they had regular care staff who arrived on time.

¿However, some people told us they were not always happy with the reliability of the service.

¿Safeguarding procedures were in place to protect people from abuse.

¿The care people received was safe. The provider had made improvements since our previous inspection in February 2018.

¿Risks to people had been identified and assessed to help manage these risks and keep people safe. The number of missed visits had reduced and people received an improved service.

¿People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

¿The provider had implemented quality assurance systems to ensure the service was operating effectively. The registered manager carried out regular audits and checks of records.

¿Further work was needed to improve some aspects of the service because we identified that communication between the provider, professionals and people who used the service required further improvement. We have made a recommendation about this. This would help to deliver a more consistent service to people.

¿People and relatives received support from staff who were kind and caring. People’s needs were met and their privacy and dignity was respected. Their independence was promoted by staff.

¿Care plans were person centred and people were supported to maintain their nutrition and hydration. They were supported to see health professionals and were prompted to take their medicines from staff who were trained.

¿People received care that was responsive to their needs and any complaints or concerns people had were investigated.

¿We made a recommendation about supporting staff to overcome language barriers with people.

¿Staff were supported and told us they had received training and supervision for their roles. Staff were recruited safely and received an induction prior to starting work.

¿The management team was committed to making improvements within the service. They learned lessons when things had gone wrong to minimise re-occurrence.

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

Rating at last inspection:

¿At the last inspection on 7 February 2018 the service was rated ‘Requires Improvement’. Our last report was published on 19 March 2018. We identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to safe care and treatment and good governance. We asked the provider for an action plan to tell us how they would make improvements.

Why we inspected:

¿This was a planned inspection based on the rating of the service at our last inspection. The inspection was part of our scheduled plan of visiting services to check that improvements had been made.

Follow up:

¿We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. A further inspection will be planned for a future date.

Verrolyne Services is based in Romford, Essex. This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults.

Not everyone using Verrolyne Services receives regulated activity; the CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

At the time of our inspection, 19 people were using the service, who received personal care. The provider employed 20 care staff.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered care homes, 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.

At our inspection, we found people did not always receive safe care because scheduled visits from care staff were missed and some people did not receive the required support at the times they expected. This was as a result of staff running late or not knowing the correct schedule.

Specific risks to people were not always fully stipulated in risk assessments to help staff identify and mitigate the risks to ensure the safety of the person and the staff. Some people expressed concern that staff did not use moving and handling equipment safely.

This meant that the provider did not always assess, monitor and mitigate risks associated with the service to ensure people received safe care. The registered manager was committed to developing the service, although further improvements were required with quality assurance systems to ensure people received a safe service.

Complaints about the service were responded to appropriately and within the provider’s timescales as set out in their complaints procedures. We have made a recommendation on ensuring more effective communication between the provider and people who use the service because people told us staff did not always understand them.

The provider had sufficient numbers of staff available to provide care and support to people. Staff had been recruited following pre-employment checks such as criminal background checks, to ensure staff were safe to work with people.

Once recruited, staff received an induction, relevant training and were able to shadow experienced staff in order for them to carry out their roles effectively.

When required, staff prompted people to take their medicines and recorded this in daily logs. Staff had been trained on how to manage medicines safely.

The provider was compliant with the Mental Capacity Act 2005 (MCA) and staff understood the principles of the Act. Staff had received supervision and training in order to provide an effective service.

Staff told us that they received support and guidance from the registered manager and other senior staff. They received regular supervision and could approach the management team with any concerns they had.

People's care and support needs were assessed and reviewed regularly.

The provider worked with health professionals if there were concerns about people's health. People were registered with health care professionals, such as GPs and staff contacted them in emergencies.

People were supported to have their nutritional and hydration requirements met by staff, who provided them with meals and drinks of their choice, when this was requested.

People were listened to by staff and were involved in their care and support planning. They were treated with dignity and respect when personal care was provided to them.

Care plans were person centred. They provided staff with sufficient information about each person’s individual preferences and how staff should meet these in order to obtain positive outcomes for each person.

People were able to access information they were able to understand to help keep them informed and safe.

Complaints about the service were responded to appropriately and within the provider’s timescales as set out in their complaints procedures. We have made a recommendation on ensuring more effective communication between the provider and people who use the service because some people did not feel staff understood them well.

The provider was in the process of introducing new technologies to help manage and improve the service.

The management team carried out regular monitoring checks on staff providing care in people’s homes. This ensured they followed the correct procedures and people received safe care.

Feedback was received from people and relatives to check they were satisfied with the service. The management team ensured lessons were learned following serious incidents.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered care homes, 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 were supported and cared for by staff who had an understanding of people’s needs and who demonstrated knowledge of safeguarding people from different types of potential abuse and how to respond. People had their individual risks assessed and had plans in place to manage them. Medicines were administered by staff that had received training to do this. The provider had procedures in place to check that people received their medicines as prescribed to effectively and safely meet their health needs.

Staff had been recruited following appropriate checks and the provider had arrangements in place to make sure that there was sufficient care workers to provide support to people in their own homes. People told us they received care from care workers who understood their preferences for care and support. However, some people had concerns about the consistency of care and the reliability of the service as there had been a number of staff changes and they were not receiving support from the same carers. We have made a recommendation about ensuring people are kept up to date with changes to their service.

People were listened to and were involved in making decisions about their care and support. Care workers were caring and supportive in the support they provided. Care workers provided support that ensured people were treated with privacy and dignity. People were supported by care workers to maintain their independence. People were encouraged to express their views and give feedback about their care. They told us that care workers listened to them and they felt confident they could raise any issues should the need arise and that action would be taken. Care workers felt supported by the registered manager and that the registered provider gave them opportunities to develop in their roles. The registered manager was committed to improving the service and developing new initiatives to support the care provided to people. The provider ensured regular checks were completed to monitor the quality of care that people received and look at where improvements could be made.