Archived: Visionshealthcare Ltd

Updated 20 April 2024

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

This inspection was carried out by 2 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. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

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. This person was also the provider of the service. They were unable to support this inspection so we met with and engaged with the providers representative who was also a director of the provider company. We have referred to them as ‘providers representative’ throughout this report.

Notice of inspection

We gave the service 12 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 20 September 2023 and ended on 3 October 2023. We visited the location’s office on 3 October 2023. There was a delay in gathering evidence for this inspection as the providers representative told us the provider and they were out of the country and there was no one available to open the office and provide us with access to the records.

What we did before the inspection

We reviewed our systems and information we held about the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We took this into account when we inspected the service and made judgements in this report.

During the inspection

We spoke with 2 people who used the service about their experience of the care provided. We also received written feedback from a further person and 2 relatives. We also had contact with 6 members of staff including care staff the provider and the providers representative. We reviewed the limited range of records available. This included care plans and staff recruitment records.

Updated 20 April 2024

About the service

Visionshealthcare Ltd is a domiciliary care agency. The service provides personal care to people living in their own homes. “At the time of our inspection there were 4 people using the service, of which 3 received personal care.

Not everyone who used the service received personal care. In this service, the Care Quality Commission can only inspect the service received by people who get support with personal care. This includes help with tasks related to personal hygiene and eating. Where people receive such support, we also consider any wider social care provided.

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

At the time of the inspection, the location did not 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.

Right Support:

People did not always receive care from consistent staff members at a consistent time each day. This compromised the quality of their care. Medicines were not managed safely. Individual risks were not being assessed or managed safely and accidents and incidents were not recorded safely, or lessons learnt. Care records did not always reflect people's preferences. 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 and in their best interests; the policies and systems in the service did not support this practice.

Right Care:

Care records including risk assessments were incomplete meaning staff did not always have the correct information on how to deliver safe care. People's care plans did not always contain sufficient information about people's needs, preferences and routines. The care people received did not always reflect their preferences and choices. Relatives did not have access to information about what care had been provided to their family member. Daily care records had been destroyed by the provider.

Right Culture:

There were no governance systems to ensure people were kept safe and received high quality care and support in line with their personal needs. This meant the provider could not be proactive in identifying issues and concerns in a timely way. Staff did not receive the training they needed to meet people's needs and deliver a safe service. The service was not submitting statutory notifications when incidents had occurred, as required.

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 good (published 14 December 2018)

Why we inspected

The inspection was prompted in part due to concerns received about a lack of responsive care and poor communication. A decision was made for us to inspect and examine those risks.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Visionshealthcare ltd on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to risk and the safe management of medicines. We also identified breaches in relation to person centred care, good governance and ensuing statutory notifications are submitted to CQC where required.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

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

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.