UK Top Care Ltd

Top UK Care Ltd is a domiciliary care agency, providing personal care to people in their own homes. At the time of our inspection there were 5 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.

Details of how to reduce risks to people's safety were included in people's care plans. Care plans reflected people’s individual needs. Enough staff were employed to meet people's needs. People and relatives said safe care was provided, with people protected against abuse, neglect and discrimination.

Staff had received training on how to keep people safe and were able to explain how these actions would be put into practice.

Effective quality assurance systems were in place to ensure people were provided with a quality service. A person using the service and relatives were satisfied with the management of the agency. They said they always received a polite and reassuring response to their queries, and any needed action had been taken.

A person using the service and relatives were very satisfied with the personal care that staff provided. They said they were treated with respect and dignity and staff had a caring and friendly approach to them.

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

Rating at last inspection

This is the fourth inspection for the service.

The last rating for this service was requires improvement (published 16 May 2023).

Why we inspected

We undertook this targeted inspection to check whether the Warning Notices we served in relation to Regulation 18 and Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met on concerns we had about the ability of staff to provide safe care and the lack of management oversight of risk.

The overall rating for the service has not changed following this targeted inspection and remains requires improvement. We use targeted inspections to follow up on Warning Notices or to check concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

Follow up

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

UK Top Care Ltd is a domiciliary care agency providing personal care and support to people in their own homes. 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. At the time of our inspection there were 6 adults who received packages of support which included personal care.Systems to assess, monitor and improve the quality of the service were not always effective. This included oversight of people's care records, staff training and competency. Quality assurance checks took place in some of these areas but these were not consistent they did not identify the issues we found during this inspection.

There was a continued lack of effective leadership. The provider’s business continuity plan did not include management contingency plans in the event the registered manager was absent. We found the service was managed by the administrative staff member with limited relevant management experience and knowledge of working in social care whilst the registered manager was on holiday.

Staff had not received induction and essential training in all key areas of care provision to help ensure they had the skills and knowledge to fulfil their roles. There was no system to support and supervise staff and to ensure staff were kept up to date about changes to people’s needs or practices. Whilst we found no evidence people

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

were harmed, they remained at risk because staff were not trained.

People and relatives told us they felt safe with the staff and the care provided. The provider understood their role to act on abuse and report it to relevant external agencies but further action was needed to ensure all staff were trained in this area.

Risks to people's safety were assessed and measures were put in place to reduce any risks.

People were supported with medicines administration and care plans detailed the level of support when this was required. Further action was needed to ensure all staff were trained to support people with medicines.

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; and policies were in place to support this practice. We have made a recommendation about the principles of the Mental Capacity Act.

There were sufficient numbers of staff who had been safely recruited to meet people's needs.

People and relatives told us staff always used PPE to protect them from risk of infectious diseases. Systems were in place to control and prevent the spread of infection.

Rating at last inspection and update

The last rating for this service was requires improvement (published 11 December 2019). 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 the provider remained in breach of regulations.

Why we inspected

We carried out an announced focused inspection of this service from 6 to 14 November 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 safe care and treatment and governance. This inspection was in part prompted by a review of the information we held about this service.

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 and well-led which contain those requirements.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this report.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for UK Top Care Ltd on our website at www.cqc.org.uk

Enforcement and Recommendations

We have identified continued breaches in relation to staffing and governance oversight systems at this inspection. We issued 2 warning notices, which required the provider must make improvements to meet the regulations.

This report only covers our findings in relation to the Key Questions; Safe and Well-led which contain those requirements. 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 requires improvement. This is based on the findings at this inspection.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor the provider's progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

UK Top Care Ltd is a domiciliary care service. The service provides personal care to people living in their own homes. At the time of the inspection there were eight people using the service.

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

The provider had not kept up to date with changes in legislation, which regulates how the service operates. The provider did not have an effective system in place to assess and monitor the service to ensure they kept up to date with good practice. This meant they were not able to continually improve the quality and safety of the service.

The provider did not have systems in place to ensure people received their prescribed medicines. People’s records did not include sufficient or consistent information about the medicines they were prescribed, and the role of staff in administering them. Staff competence to administer medicines was not assessed. Staff had received training in safeguarding, however staff were not able to tell us about external organisations they could contact to report abuse.

People’s safety was promoted by staff who followed guidance on how to reduce potential risk. This included the use of equipment to support people moving around their home. People were supported by sufficient numbers of staff who had undergone a robust recruitment process.

People’s needs and expectations of care were assessed, and used to develop a package of care to support the person at home, which included the staff members role in promoting choice. We found 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’s needs were met by sufficient numbers of staff and who were supported through ongoing training.

People were supported by a core group of staff, many of whom having provided care and support over several years to the same person, which had supported people in developing trusting relationships with staff. Staff reflected the cultural diversity of those using the service, who were able to meet all their needs, which included effective communication, as staff were able to converse in people’s preferred language.

People and family members were involved in the development of care plans, which provided guidance for staff to enable them to provide the care and support each person had agreed was appropriate to them. However, we found care plans were not always clear as to whether staff or family members were responsible for some aspects of people’s care. The provider had not received any complaints, and family members told us should they need to raise concerns, they were confident these would be addressed.

Family members spoke positively of the registered manager, saying they were approachable, and often visited them in the family home to assure themselves of people’s welfare. The registered manager sent out surveys seeking people’s views of the service, which showed people were satisfied with the service they received.

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 this service was good (published, 5 May 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to medicine management and the governance of the service at this inspection.

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 to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

UK Top Care Limited provides personal care and treatment for adults living in their own homes. At the time of our inspection the service supported 13 people who lived within the city of Leicester.

The service has a registered manager. This 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.

We had mixed comments about the service people received. Most people told us they were pleased with the service and the registered manager and staff listened to them, wanted to hear their views, and kept them informed about the service. One person had a number of late calls recently and another was unhappy with one staff member’s attitude. Relatives said the registered manager and staff were approachable and they were kept up-to-date with their family member’s progress and any changes or developments at the service.

The service provided safe care. Staff were trained in safeguarding (protecting people from abuse) and knew how to keep people safe. Some information about safeguarding and whistleblowing had not been updated in the staff handbook.

Staff took a flexible approach to the people they worked with regularly assisting with additional household tasks. Staff provided people with the care and support they wanted and encouraged them and their relatives to be an active part of the care planning process.

Staff ensured people were having enough to eat and drink. Staff had been trained to assist people to take their medicines safely and in the way they wanted them. People were treated with dignity and respect.

The provider and registered manager carried out audits of all aspects of the service to ensure it was well-led. People’s and relative’s views were encouraged to assist the development of the service.