We carried out a review of the data available to us about Support Care Services on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Support Care Services, you can give feedback on this service.
Support Care Services is a domiciliary care agency that provides personal care to people living in their own houses and flats in the community. CQC only inspects the service being received by people provided with ‘personal care’, that is help with tasks related to personal hygiene and eating. Where they do this, we also take into account any wider social care provided. At the time of our inspection there were five people using the service.
People’s experience of using this service and what we found
The quality and safety of the service had improved for people since our last inspection. The registered manager had made sure all staff received the training they needed to help them meet the range of people’s needs. Changes had been made to recruitment and selection processes to reduce the risk of people being supported by unsuitable staff. The quality of information recorded by staff about the support people received had improved which helped keep everyone involved in people’s care up to date about their current health and wellbeing. The quality monitoring system had been updated so audits and checks now covered those areas of the service where we previously found issues. This helped reduce the risk of these reoccurring.
The registered manager’s knowledge and understanding of legal requirements had improved. But there was some inconsistency around how they applied this in some instances. The registered manager was not always clear about when to tell us about events and incidents involving people. We also found the rating from the last inspection was not clearly displayed on the new website for the service, to inform people and others about the quality and safety of the service. The registered manager took immediate action after this inspection to ensure the rating was clearly displayed.
People received their medicines as prescribed. But, medicines records were not always maintained in a consistent way. The registered manager was already aware of this and was working with a dispensing pharmacist to improve the quality of information for staff about medicines, so that this could be properly recorded.
People received the care and support planned and agreed with them. Their choices for how support was provided were respected and staff delivered this in line with their wishes. There were enough staff to meet people’s needs. Staff knew people well and understood their needs and how these should be met.
Staff were encouraged to treat people with respect, maintain their dignity and privacy and to encourage their independence wherever possible, especially when being supported with their care needs. 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.
People were helped to eat and drink enough to meet their needs. Staff demonstrated they knew what people’s healthcare needs were and how they should be supported with these. They reported any issues and concerns about people promptly so that appropriate support could be sought for them, especially if they became ill.
Staff were trained to safeguard people from abuse and to report any concerns they had to the appropriate person and agencies. Staff knew how to manage and minimise identified risks to people’s safety and wellbeing. They followed good practice when providing personal care and when preparing and handling food which reduced hygiene risks.
People, their representatives and staff were encouraged to have their say about how the service could improve. The registered manager investigated all events, incidents and complaints and kept people involved and informed of the outcome. Learning from investigations was shared with staff to help them improve the quality and safety of the support they provided. The registered manager worked in partnership with other agencies and healthcare professionals to make sure people received the care and support they needed.
New technology was being introduced to improve the service further. This would give staff secure access through mobile smart phones to information about people’s care and support needs. The registered manager told us this would help them monitor that people were getting the right care and support at the right time.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
Rating at last inspection and update
The last rating for this service was requires improvement (published 30 August 2018) and there were two breaches of regulation. Since this rating was awarded the registered provider of the service has moved premises. We have used the previous rating to inform our planning and decisions about the rating at this inspection. 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 improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Support Care Services is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. At the time of our inspection four people were using the service. CQC only inspects the service being received by people provided with ‘personal care’, that is help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.
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 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.
At this inspection we identified issues which indicated that the registered manager’s current knowledge and understanding for meeting these requirements was inconsistent. Staff did not receive all the training they needed, at the appropriate time, to help them meet people’s needs effectively. However, they were provided regular opportunities by the registered manager to reflect on their work practice and identify how they could improve in their role.
We checked whether the service was working within the principles of the Mental Capacity Act (MCA) 2005 and found staff had not received relevant training about their responsibilities in relation to the Act. All the people using the service at the time of this inspection could make and consent to decisions about their care and support. However, there was a risk staff may act unlawfully if a person became unable to make an informed decision or consent to their care and support.
The provider carried out checks of staff’s suitability and fitness to support people as part of their recruitment arrangements. However, they did not routinely check the authenticity of references provided in support of staff’s applications which meant they did not have all the assurances they needed about staff’s suitability to support people. The registered manager said they would be taking immediate action after this inspection to rectify the issues we found.
In relation to other aspects of their role, the registered manager demonstrated good awareness of their registration responsibilities particularly with regards to submission of statutory notifications about key events that occurred at the service. People spoke positively about the registered manager and said they were approachable and available when needed.
People were safe when being supported by staff. Staff were supported to take appropriate action to ensure people were protected if they suspected they were at risk of abuse. Staff had access to current information and guidance on how to minimise identified risks to people due to their specific needs. This helped to keep people safe from injury or harm.
There were enough staff to meet people’s needs. People experienced continuity and consistency in the support they received from staff. Staff followed good practice to ensure risks to people were minimised from poor hygiene and cleanliness when providing personal care and when preparing and handling food.
Staff supported people to take their prescribed medicines and to eat and drink sufficient amounts to meet their needs. Records maintained by staff after each scheduled visit were limited and did not always help to keep others well informed and up to date about people’s current health and wellbeing. However, when staff had a concern about this they took prompt action so that appropriate support could be sought for the person. The registered manager was working with staff at the time of this inspection to improve the quality of the records they maintained
People commended staff for their conduct and care. Staff provided support that was dignified, respectful and which maintained people’s privacy. They also supported people to be as independent as they could be and wanted to be. Where they were responsible for this, staff helped people to engage and pursue activities and personal interests to help promote their overall wellbeing.
People’s needs had been assessed in line with current legislation and standards. People contributed to the planning of their care and support. Their care needs and specific preferences for how these should be met were set out in their support plan. People’s needs were reviewed with them. Their support plans were updated as their needs changed to ensure staff had up to date information about the support people required.
People were satisfied with the care and support they received. People knew how to make a complaint if needed and the provider had appropriate arrangements in place to deal with these.
The provider sought people’s and staff’s views about the quality of care and support provided and how this could be improved. They used this information along with other audits and checks to monitor and review the quality and safety of the support provided. Any shortfalls or gaps identified through these checks were addressed promptly.
The provider worked in partnership with healthcare professionals involved in people’s lives to develop and improve the delivery of care. This helped to ensure people continued to receive the appropriate care and support they required.
At this inspection we found the provider in breach of legal requirements with regards to requirements relating to registered managers and staffing. You can see what action we told the provider to take with regard these breaches at the back of the full version of the report. We have also made a recommendation about staff training on the subject of the MCA.