Sterling Support Services

Updated 3 September 2019

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 to provide a rating for the service under the Care Act 2014.

Inspection team:

There was one inspector.

Service and service type

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 and disabled adults.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 24 hours’ notice of the inspection visit because it is small, and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

Inspection site visit activity started and ended on 30 July 2019. We went to see the manager there, and to review care records and policies and procedures.

What we did before inspection

We reviewed information we had received about the service. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with the registered manager. We reviewed a range of records. This included two people’s care records, one currently using the service and one no longer using it, and their medicines records. We looked at two staff files in relation to recruitment and staff supervision in addition to a variety of records relating to the management of the service, including policies and procedures.

After the inspection

We spoke with one relative of a person who used the service about their experience of the care provided. We spoke with two members of staff. We received supporting evidence from the registered manager highlighting positive changes they had made to the service.

Updated 3 September 2019

About the service:

Sterling Support Services is a domiciliary care agency that was providing personal care to a limited number of people at the time of the inspection.

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

Recruitment practices were not robust and did not ensure people were kept safe. Risks to people were not always properly recorded and measures were not in place to keep people safe. At the time of our inspection, people did not require support with medicines, however the service did not record the administration of medicines properly for people who formerly used the service that required support. The service had not completed any audits on medicine administration. Effective systems were not in place to learn from lessons following incidents.

There were systems and processes in place to safeguard people from harm and abuse. There were enough staff to provide care. People were protected from infection through infection prevention measures.

People’s needs were assessed before they began using the service, but their preferences were not recorded. People were supported to eat and drink but their preferences around diet and recording of specific dietary needs were not recorded. People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible; the policies and systems at the service did not support this practice. Staff received inductions and training in their roles. Staff also received supervisions. Staff worked with other agencies, including healthcare professionals, to the benefit of people’s care. The outcomes for people did not fully reflect the principles and values of Registering the Right Support for the following reasons; people’s care plans did not indicate their preferences and therefore were not person centred. There appeared to be little input from people into their care plan completion.

Relatives told us people were treated well by staff. The service was inclusive and promoted people’s human rights. Relatives told us they had input into people’s care and treatment though documents were not always signed. We have made a recommendation about this. Relatives told us people’s privacy and dignity were respected, and their independence promoted.

Care plans provided guidance for staff on how to best work with people but did not record people’s preferences. Records indicated that people were supported to complete activities they enjoyed. The service had not recorded or identified the best methods in which to communicate with people in a personalised way. Relatives told us they knew how to make complaints but had not needed to do so. The service was not supporting people with end of life care.

Relatives and staff spoke highly of the registered manager. The service completed quality assurance processes in the hope of providing continuous improvement to people’s care and ensuring their safety, though this had not identified the shortfalls we found at the inspection. Relatives and staff were able to give feedback to the provider through meetings. There were plans to implement people, relatives and staff surveys to drive improvement.

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 31 August 2016 and this was the first inspection.

Why we inspected

This was a planned inspection that was part of our inspection schedule.

Enforcement

We have identified breaches in relation to fit and proper persons being employed, person-centred care and consent to treatment 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 for the provider to understand what they will do to improve the standards of quality and safety. We will monitor the progress of the improvements working alongside the provider and local authority. We will return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.