Background to this inspection
Updated
13 February 2020
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 Care Act 2014.
Inspection team
The inspection team was made up of one inspector and one inspection manager.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
The service has a manager registered with CQC, who is also the nominated individual for the provider organisation. A nominated individual is a person who is responsible for supervising the management of the service on behalf of the provider. As well as being the registered manager of the service and also being the nominated individual, they are also the only director of the provider organisation. This means they alone are legally responsible for how the service is run and for the quality and safety of the care provided. In this report, due to the person's multiple roles, we will refer to them as the registered person.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure the registered person would be in the office to support the inspection. Inspection activity started on 25 July 2019 and ended on 2 August 2019. We visited the office location on 25 July 2019.
What we did before the inspection
The registered person was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We reviewed all the information we had collected about the service since the last inspection. This included monthly provider reports relating to how they were ensuring their compliance with the fundamental standards. Other information reviewed included previous inspection reports, information received and notifications the registered person had sent us. A notification is information about important events which the service is required to tell us about by law. We used all of this information to plan our inspection.
During the inspection
We spoke with the registered person and the administration assistant. We reviewed a range of records. This included four people’s care records and associated medicine administration record sheets. We looked at all (six) staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed. A number of records were not readily available at the inspection, so we provided a list of outstanding information to be sent to us after the inspection.
After the inspection
We continued to seek clarification from the provider to validate evidence found at the inspection and sent to us after. We looked at training data and quality assurance records. We sought feedback from six health and social care professionals and received responses from three. We sought feedback from all five care workers and received a response from two. We spoke with three people who use the service and three of their relatives.
Updated
13 February 2020
About the service
People Matter Support Services Limited is a domiciliary care agency. It provides personal care to people living in their own homes in the community. Not everyone using People Matter Support Services Limited receives personal care. The Care Quality Commission only inspects the service being received by people provided with help with tasks related to personal care, hygiene and eating. It provides a service to older people, younger adults and also those with learning disabilities and/or those on the autistic spectrum. They have detailed in their statement of purpose that they can provide a personal care service to children aged up to 18 years, however, at the time of this inspection, the 14 people using the service were all adults.
People’s experience of using this service and what we found
The registered person had not established an effective system to enable them to ensure compliance with their legal obligations and the regulations. They had not established an effective system to enable them to assess, monitor and improve the quality and safety of the service provided. The lack of robust quality assurance meant people were at risk of receiving poor quality care and, should a decline in standards occur, the provider's systems would potentially not pick up issues effectively.
People were not always protected from risks to their health and wellbeing. Risks to people who use the service were not always identified or addressed to reduce or remove risks. The registered person had improved staff training and recording of medicines. We have made a recommendation about staff who assess staff competence to handle medicines.
The registered person had not made sure staff employed were of good character and that all required information and checks were carried out. This meant people were at risk of staff being employed to work with them who were not suitable.
People were at risk of potential harm because the registered person had not ensured the staff providing the care had the qualifications, competence, skills or experience to do so safely. The registered person had not ensured staff were provided with appropriate training as was necessary for them to do their job safely and effectively.
People and their relatives felt the care and support they received helped them to be as independent as possible. They were happy with their care and felt the staff were kind and treated them with respect and dignity. People's needs relating to communication were not recorded in a way that met the Accessible Information Standard.
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 overall rating for this service was requires improvement (reports published 24 October 2018 and 25 April 2019).
The provider completed an action plan after the last comprehensive inspection in August 2018 to show what they would do and by when to improve.
After our focused inspection in December 2018 we found the provider remained in breach of the regulations and we imposed two conditions on their registration.
At this inspection not enough improvement had been made and the provider was still in breach of regulations.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
You can read the report from our last comprehensive inspection, and the last focused inspection by selecting the ‘all reports’ link for People Matter Support Services Limited on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to regulations 9, 12, 17, 18 and 19 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 at this inspection. People were not always protected from risks to their health and wellbeing; staff recruitment and training were not adequate to ensure people were safe or staff were competent and suitable for their roles; effective systems were not in place to ensure the service met the required fundamental standards of care. People's needs relating to communication were not recorded in a way that met the Accessible Information Standard.
We have imposed four conditions on the provider's registration and asked them to send an action plan regarding actions they will take to meet the Accessible Information Standard.
Follow up
We met 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 progress. We will continue to monitor intelligence we receive about the service and we will return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.
Special Measures
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it, and it is no longer rated as inadequate for any of the five key questions, it will no longer be in special measures.