Archived: Visionshealthcare Ltd

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.

On the day of our comprehensive announced inspection on 14 November 2018, there was one person using the service. We gave 24 hours’ notice of this inspection to make sure that the person who used the service and staff would be available to speak to us. This was the first inspection of the service.

The service had a registered manager. 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.

Care plans and risk assessments had been written from an assessment of the person’s needs. The staff were aware of the contents of the care plans so that they understood the person’s needs and how to support them to meet their desired goal.

There were systems in place designed to reduce the risks of abuse and avoidable harm. The staff had received training in the safeguarding of people. The staff did not support people with their medicines but would receive training to do so once the service developed and medicine administration was necessary. The service had sufficient members of staff to cover the rota and the systems to recruit staff safely were robust. The staff had received training in infection control.

Staff were trained and supported to meet the person’s needs. Although staff had not received training in the Mental Capacity Act 2005, they did have knowledge of this subject and the registered manager was arranging staff training in this subject. The person’s nutritional needs were assessed and met. The person was supported to have maximum choice and control of their life and staff supported them in the least restrictive way possible.

The person who used the service shared positive relationships with the staff. Their privacy, independence and dignity was respected. People were listened to in relation to their choices, and they and their relatives, where appropriate, were involved in their care planning and the review of the care provided.

The person received a responsive service. There were systems in place to assess, plan and meet their individual needs and preferences. There was a complaints procedure in place.

The director told us the aim of the service was to deliver quality care. This required the care plans of the individuals using the service to be person-centred and for the staff to understand those principles. The service provided was assessed and monitored by the senior staff to provide people with a service of which they were satisfied.