Background to this inspection
Updated
21 September 2023
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
The inspection consisted of 2 inspectors, 1 nurse specialist advisor and 2 Experts 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 homes.
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.
Notice of inspection
We gave the service 48 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 19 June 2023 and ended on 27 June 2023. We visited the location’s office on 19 June 2023.
What we did before the inspection
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 used this information to plan our inspection.
During the inspection
We spoke with 16 people and 4 relatives about their experience of care provided. We spoke with 17 members of staff including the registered manager, recruitment team, quality lead, clinical manager and support workers. We reviewed a range of records including 11 peoples care and support plans and medication records. We also reviewed a range of documents relating to the running of the service, this included audits and 3 staff files.
Updated
21 September 2023
Active Care Group – South Division care in the home is a domiciliary care agency providing personal care and treatment of disease, disorder or injury to people in their own homes. The service provides specialist support to adults and children who have sustained complex and life changing injuries such as an acquired brain injury. At the time of our inspection there were 86 adults and 32 children using the service, a total of 118 people.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is support 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
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Right Support
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. People did not have mental capacity assessments or best interest meetings to ensure decisions being made on their behalf were the least restrictive. Staff enabled people to access specialist health and social care support in the
community.
Right Care
People's individual health risks were not always well managed to ensure they received to care and support needed. People were not always supported by staff who had the skills and knowledge needed to meet their needs. People's care plans did not always reflect their range of needs. For example, risk assessments did not always detail enough guidance for staff to support people safely. People’s equality and diversity was not considered in their care and support plans. People did not have end of life care plans.
Right Culture
Staff told us they did not always feel supported by senior management at the service. Staff had not always had training in areas which would enable them to support people with all their identified needs. Staff had not completed training in learning disability and/or Autistic people, positive behaviour support or end of life care. People and staff felt communication with the office and senior management was poor.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 08 August 2018)
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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 ‘Active Care Group – South division care in the home’ on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to safe care and treatment, supporting people with decision making under the Mental Capacity Act, person centred care and good governance.
Please see the action we have told the provider to take at the end of this report.
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 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.