Background to this inspection
Updated
15 June 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 completed by an inspector and an 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 and specialist housing.
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. They were also the provider.
Notice of inspection
We gave the service short notice of the inspection to ensure staff we needed to speak with would be available.
Inspection activity started on 19 May 2023 and ended on 23 May 2023. We visited the location’s office on 19 and 22 May 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 since registration. We sought feedback from commissioners. We used all this information to plan our inspection.
During the inspection
We spoke with 6 people and 5 relatives. We also spoke with the registered manager, the compliance and quality assurance manager, 3 office-based staff and 6 care staff. We reviewed 4 people’s care records and 3 staff recruitment files. We also reviewed records related to the management of the service.
Updated
15 June 2023
About the service
Expert Care Solutions Ltd Fleet is a domiciliary homecare provider registered to provide personal care to adults, who may have a physical or learning disability, sensory impairment or dementia. They also provide care for people with an eating disorder. At the time of our inspection there were 76 people using the service.
People’s experience of using this service and what we found
People provided mixed feedback about their care. Some people felt they had experienced poor care from staff and reported they felt unsafe with them.
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 provide 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.
The registered manager who was also the provider did not fully understand all of the legal requirements and their responsibilities. There had not been sufficient oversight of the service. Monitoring systems and processes had not been operated robustly, to drive improvements for people.
The provider had not operated fully robust staff recruitment processes. There had been a failure to ensure all people’s care calls were scheduled and delivered safely. A missed care call had not been reported to the relevant authority. The registered manager had not ensured all people had risk assessments in place. There was a lack of guidance for staff about the safe management of people’s health conditions. Processes and procedures were not sufficiently robust to ensure people’s medicines were always administered safely or recorded. Some people reported staff did not always wash their hands when providing their care.
People were not supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests; but the policies and systems in the service did not support this practice.
People did not all report they felt well treated by staff who provided their care. Some people felt staff lacked compassion and an interest in them. Although records showed people’s views about their care were sought, not everyone reported they felt listened to. People overall felt staff respected their dignity and privacy during the provision of their care.
The provision of people’s care was based on an assessment of their needs. People’s care was planned with them or their representative.
Staff received training for their role, and supervision and spot checks of their work. Staff supported people to eat and drink sufficient for their needs. Staff worked both together and across organisations to co-ordinate people’s care between services. Staff had completed end of life care training.
People did not all feel the service was well-led. However, staff felt well supported in their role. Staff worked with external providers and commissioners in the planning and provision of people’s care.
People were provided with information about how to complain and complaints were investigated.
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 9 August 2022 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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.