Quantum Domiciliary Care Limited

Updated 21 February 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 was completed by 2 inspectors.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

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 24 hours’ notice of the inspection. This was because the service is small, and people are often out, and we wanted to be sure there would be people available to speak with us.

Inspection activity started on 13 December 2022 and ended on 26 January 2023. We visited the location’s office on 13 December 2022.

What we did before the inspection

We reviewed the information we had received about the service. We sought feedback from the local authority and professionals who work with 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 used information gathered as part of monitoring activity that took place on 9 November 2022 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.

During the inspection

We spoke with 5 relatives of people who used the service about their experience of the care provided and 1 person receiving support. We spoke with 9 staff, including the registered manager, care manager, senior care staff and care staff. We reviewed a range of records. These included the people’s care records and medication records. We looked at 2 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 21 February 2023

About the service

Quantum Domiciliary Care Limited is a domiciliary care agency providing personal care to people living in their own homes. The service provides support to people living with dementia, older and younger adults, people with learning disabilities and autism and people with physical disabilities. At the time of our inspection there were 17 people using the service.

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.

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

Right Support

Recording of some aspects of care was not always clear and made monitoring of risks more difficult. Guidance for staff on how to apply creams was not clear for some people. An ‘as needed’ medicine for 1 person did not have any guidance for staff on why and when to use it. People were supported by safe numbers of staff and were mainly supported by the same staff group. People received support tailored to their individual needs. Relatives told us they were happy with the support their loved ones received.

Right Care

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. Staff knew people well and knew how they wanted to receive care. They understood what people could do for themselves and what they needed support with.

Right Culture

Some people’s care plans did not always include enough guidance for staff on how to support them with their care needs. Some care plans had not been updated with new guidance from other health professionals. Systems were in place to help staff monitor the quality of care plans, but they had not helped to identify the concerns we found. However, people were supported by the same staff who knew their care needs well and were aware of the updated guidance. The registered manager had not kept updated with national guidance. This meant staff had not received training to support people with learning disabilities and autism. This is now a legal requirement of the Health and Care Act 2022. We found no evidence that people had been harmed or were receiving inappropriate care as a result of this. People and their loved ones were involved in the planning and review of their care. Relatives told us they could get in touch easily with the management team and found them to be supportive. Staff told us they felt there was an open culture of learning in the team and the management were supportive. They spoke positively about the staff team and the managers.

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.

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 16 November 2019).

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 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.

Enforcement

We have identified breaches in relation to the quality assurance and governance systems in place at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.