Superhealthcare

Superhealthcare is a domiciliary care service providing the regulated activity of personal care to people. The service provides support to people in their own home. At the time of our inspection there were 3 people using the service.

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

People told us they were safe and there were no concerns about their safety. Suitable arrangements were in place to protect people from abuse and avoidable harm. Staff understood how to raise concerns and knew what to do to safeguard people. Enough numbers of staff were available to support people safely and since our last inspection to the service, an electronic call monitoring system had been introduced. Risks to people’s safety and wellbeing were assessed and recorded. Appropriate arrangements were in place to ensure people received their medication, records were maintained to a good standard and staff appropriately trained. People were protected by the service’s prevention and control of infection arrangements.

Suitable arrangements were in place to ensure staff were trained. Staff felt valued and supported by the management team. People were supported with their dietary requirement needs. The service ensured they worked collaboratively with others and people were supported to access healthcare services when needed. 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 support this practice.

People and their relatives confirmed they and their family member were treated with care, kindness, respect, and dignity. People were consistently reassuring about staffs caring attitude, confirming there were positive interactions with staff. People told us the service was well managed. Quality assurance arrangements enabled the provider and registered manager to monitor the quality of the service provided and staff performance.

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 June 2023].

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.

This service has been in Special Measures since 4 June 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We carried out an announced comprehensive inspection of this service in April 2023. Breaches of legal requirements were found relating to the provider’s governance arrangements and recruitment practices and procedures.

The provider completed an action plan after the last inspection to show what they would do and by when to improve their medicines management and governance and quality assurance arrangements.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe, Effective and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

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

Follow up

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

Superhealthcare is a domiciliary care service providing the regulated activity of personal care. The service provides support to people living in their own homes. At the time of our inspection there were 4 people using the service.

CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. All people using the service were receiving the care package of personal care.

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

Whilst the provider had made some improvements since our last inspection in July 2022, the provider was still required to ensure effective oversight and ongoing sustainability and improvement in the longer term to demonstrate compliance with regulatory requirements. Some improvements were still required to the service’s recruitment, induction, supervision and medication practices and procedures, and to their call monitoring arrangements. Recommendations have been made relating to induction and supervision.

Relatives told us their family member was safe and they had no concerns about their safety. Suitable arrangements were in place to protect people from abuse and avoidable harm. Staff understood how to raise concerns and knew what to do to safeguard people. Risks to people’s safety and wellbeing were assessed, recorded, and followed by staff. Enough numbers of staff were available to support people safely. People were protected by the service’s prevention and control of infection arrangements.

People and relatives spoke positively about the kind and caring attitude of staff. People’s care and support needs were clearly documented, and staff had a good understanding and knowledge of these and the care to be delivered. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Suitable arrangements were in place to ensure staff were appropriately trained. Staff told us they felt valued and supported by the provider. People were supported with their dietary requirement needs. The service worked collaboratively with others and people were supported to access healthcare services when needed. Relatives told us the service was well managed.

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 Inadequate [published September 2022].

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 12 [Safe care and treatment] and 18 [Staffing]. However, we found the provider remained in breach of Regulation 17 [Good governance] and Regulation 19 [Fit and proper persons].

Why we inspected

This inspection was prompted by a review of the information we held about this service and to follow up on action we told the provider to take at the last inspection.

Enforcement and Recommendations

We have identified a breach in relation to the provider’s quality assurance and governance arrangements 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 from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Requires improvement’. However, we are placing the service in 'special measures'. We do this when services have been rated as 'Inadequate' in any Key Question over two consecutive comprehensive inspections. The ‘Inadequate’ rating does not need to be in the same question at each of these inspections for us to place services 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, 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.

Superhealthcare is a domiciliary care service providing personal care for people living in their own homes. At the time of our inspection there were six people using the service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

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

Recruitment practices continue to not be safe and operated in line with regulatory requirements. Quality assurance arrangements remain unreliable and ineffective to identify shortfalls and make the required improvements. Improvements were required to ensure the proper and safe use of medicines. We could not be assured all staff employed at the service had received appropriate training or induction. The provider’s supervision and ‘spot visit’ arrangements required improvement.

Information relating to people's individual risks were now recorded for the safety of people using the service. People and those acting on their behalf told us they or their family member were safe. People told us they had not experienced any occasions whereby they had not received support from the domiciliary care service. Staff enjoyed working at the domiciliary care service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, where restrictions were in place for individual people, the reason for the restriction was not recorded to evidence these had been agreed.

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 inadequate [published January 2022].

The provider completed a monthly report after the last inspection to show what they were doing to improve. At this inspection we found the provider remained in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service remains Inadequate.

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

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified continued breaches in relation to the provider’s governance and recruitment procedures at this inspection.

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 receive a monthly report from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and Local Authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service remains 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.

Superhealthcare is a domiciliary care agency providing personal care to people in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection the service was providing personal care to 10 people.

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

The registered manager had failed to assess people’s risks and document these or put in place robust care plans. There was a lack of information to support staff with people’s needs such as mobility, catheter care and managing risks.

The registered manager had failed to ensure staff were recruited safely. Documents and checks required to show staff are suitable to work with people had not been completed before staff started working for the registered manager. The registered manager failed to provide evidence to show staff had the correct training and competence for their role.

The registered manager was not following current government guidance in relation to infection control. Staff were not undertaking the correct testing for COVID-19 which placed people at risk of being exposed to the virus.

Whilst people told us they were happy with the care provided, there were widespread and significant shortfalls in the way the service was led. Governance and quality assurance systems were not in place to monitor the service and ensure people were receiving safe and appropriate care, placing people at the risk of harm.

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 inadequate (7 June 2021) and there were multiple breaches. The registered manager completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, improvements had not been made and the provider was still in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to the management of risk, safe staff recruitment, safeguarding and continued weakness in the management of the service at this inspection. 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 requested an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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 six 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.

Super Healthcare Limited is a domiciliary care agency providing personal care to people in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of the inspection we were given contact details for six people, however this was not correct and we unable to ascertain how many people the service was supporting.

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

People’s risks and care needs had not been properly assessed or documented. There was a lack of information about how staff should support people with needs such as mobility, diabetes and medicines.

The registered manager had failed to ensure staff were recruited safely. There were no records to show if staff working for the provider were of a suitable character to work with vulnerable people.

The registered manager was not following current government guidance in relation to infection control. Staff were not taking part in regular testing for COVID-19 which placed people at risk of being exposed to the virus.

There were widespread and significant shortfalls in the way the service was led. Governance and quality assurance systems were not in place to monitor the service and ensure people were receiving safe and appropriate care.

The registered manager had failed to act on the findings of the previous inspection and make improvements to the way the service was run.

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 27 April 2020) and there were multiple breaches. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, improvements had not been made and the provider was still in breach of regulations.

Why we inspected

The inspection was prompted in part by notification of a specific incident. Following which a person using the service sustained a serious injury. This incident is subject to a criminal investigation. As a result, this inspection did not examine the circumstances of the incident.

The information CQC received about the incident indicated concerns about the management of people’s care in relation to scalding. This inspection examined those risks.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to the management of risk, safe staff recruitment and weaknesses in the management of the service at this inspection. 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 requested an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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 six 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.

Superhealthcare is a domiciliary care agency registered to provide personal care. At the time of the inspection three people were receiving care.

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

We have made recommendations to provide staff training over more than one day and to include end of life training as part of staff training. We also recommended the registered manager looks to join local networks and forums.

Staff were not recruited safely. The registered manager had failed to apply for Disclosure and Barring Service (DBS) checks for new staff. References had not been requested from previous employers and reasons for leaving previous employment had not been investigated.

Medicines were not always managed safely. There were no clear records to indicate the level of support people needed to take their medicines or how they should be given. There were no audits of medicine administration records (MAR). There were no care plans or risk assessments in place to identify people’s needs and risks and explain how staff should look after people and manage their risks.

People had not received an assessment of their needs. There were no care plans in place to support staff in delivery person centred care. Staff were completing daily records however, these were not being formally reviewed. We did not see any evidence of people’s care being reviewed, however, people told us they were involved with how their care was provided.

There were no quality assurance measures in place. Spot checks were not being formally completed or recorded. There were no audits in place to monitor the service. People and staff had not been asked to complete surveys, however both staff and people using the service told us they provided the registered manager with feedback. There were no formal staff meetings or supervisions taking place and records had not been kept. There were no links with the local community. The registered manager did not attend forums or conferences and were not part of any local forums to assist them in improving the service they offered to people.

Staff knew how to recognise signs of abuse and knew who to contact. People told us they felt safe with their carers. Staff understood the importance of infection control.

Staff had received an induction and training that was suitable for their role. People told us their carers were well trained and were happy with the care they received.

People told us carers were kind and provided their care in a caring and compassionate way. Staff treated people with dignity and respect and promoted people’s independence.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People were supported to eat and drink. People were supported with healthcare where necessary. Staff communicated with other agencies on behalf of people where necessary.

Staff knew about people’s communication needs, and people were supported to receive communication in a way they wanted. There had been no complaints since the service started operating, people and relatives told us they knew how to complain.

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 22/03/2019 and this is the first inspection.

Why we inspected

This was a planned inspection based on our inspection programme.

Enforcement

We have identified breaches in relation staff recruitment, safe care and how the registered manager monitors how the service is run.

We are mindful of the impact of COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service to keep people safe.

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 from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.