Archived: Vital Healthcare Services Limited

Updated 11 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

One inspector carried out this announced inspection on 17 and 18 October 2018. We gave the service 48 hours’ notice of the inspection site visit because some of the people using it could not consent to a home visit from an inspector, which meant that we had to allow the service time to arrange for a ‘best interests’ decision about us visiting people.

Before our inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service: what the service does well and improvements they plan to make. We looked at information we held about the service including notifications they had made to us about important events. We also reviewed all other information sent to us from other stakeholders for example the local authority and members of the public. We observed how staff supported people when we visited them in their own homes.

We looked at records in relation to four people’s care and spoke with four people who used the service and one person’s relative. We spoke with the registered manager, the provider, two care coordinators, three care staff and one healthcare professional. We looked at records relating to the management of the service, four staff recruitment records, training, and systems for monitoring the quality of the service.

Updated 11 January 2019

Vital Healthcare Services Ltd provides care and support to people living in a supported living setting, so that they can live in their own home as independently as possible. People’s care and housing is provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

This announced inspection was started on 17 October 2018 and we continued the inspection for another day on 18 October, we gave the service 48 hours’ notice of the inspection site visit because some of the people using it could not consent to a home visit from an inspector, which meant that we had to allow the service time to arrange for a ‘best interests’ decision about us visiting people.

On the day of our inspection 20 people were using the service, some of whom were receiving 24-hour support.

There was a registered manager in post. 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.

We last inspected this service in May 2017 and rated the service as Requires Improvement in all key questions except Caring, which we rated as good. This meant that the service was rated as Requires improvement overall. We found the service was in breach of two regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

During that inspection, we found that people who used the service were not always safe and well cared for. Staff had received medicines training, but medicines were not managed safely as people had not always been given their prescribed medicines and medicine records had not always been completed accurately. Risks assessments were in place, but staff had not always followed the care plan which had put people at risk of unsafe care.

During that previous inspection we also found that staff were not supported well enough to carry out their roles, staff supervision was not consistent and staff had not used their training to de-escalate situations effectively. Staff had acted in a reactive rather than a proactive way and acted in a reactive rather than a proactive way. People did not always have care plans in place when they began to use the service. There was a complaints policy and procedure but the actions taken as a result of complaints had not fully addressed the situation. The quality assurance systems were not robust enough and had not identified the concerns we found during that inspection in May 2017.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the quality of care and support people received to at least good.

During this inspection on 17 and 18 October 2018, we found that significant improvements had been made towards meeting the requirements to help ensure that people received an improved quality of service and there were no longer any breaches of regulation.

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.

The service was well led; the registered manager was knowledgeable about the people being supported and has recruited a care coordinator and an operations manager since our last inspection to improve the running of the service. People, their relatives and staff told us that there had been improvements in the way the service was run since our last inspection in May 2017 and that the registered manager was supportive and had good management skills. Staff told us that they recognised the hard work the registered manager had put into the service to improve the service offered to people. There were systems in place to monitor the quality of service offered to people.

People could express their views and staff listened to what they said, respected their views and took action to ensure their decisions were acted on. Staff protected people’s privacy and dignity.

People and their relatives told us that they were confident they were safe in this service. People were protected from bullying, harassment, avoidable harm and abuse by staff that were trained to recognise abusive situations and knew how to report any incidents they witnessed or suspected. Staff understood their responsibilities to raise concerns and there were arrangements in place for reviewing and investigating incidents when things went wrong. Staff told us they would not hesitate to report any suspicions they had about people being abused. Staff had been safely recruited which helped protect people from harm.

Risks were assessed and steps had been put in place to safeguard people from harm without restricting their independence unnecessarily. Risks to individual people had been identified and action had been taken to protect them from harm.

Staffing levels were sufficient to keep people safe and people were supported to manage their medicines in a way that ensured that they received them safely and at the right time. There were also appropriate infection control practices in place to help protect the people the service supported and the staff from the risks involved around contagious diseases.

People’s needs assessments were detailed and they received effective care in line with current legislation from staff who had the knowledge, qualifications, skills and experience they needed to carry out their roles.

The management and staff worked together with external healthcare professionals to ensure that people received consistent person centred care when they used or were supported by different services. People were asked for their consent by staff before they supported them.

Staff offered advice to people to help them make healthy decisions around food and supported them to eat and drink enough to maintain a balanced diet. People were also supported to maintain good health and gain access to healthcare services when they were needed.

People received care that was individualised and responsive to their needs. The service listened to people’s experiences, concerns and complaints. They acted to investigate people’s complaints, learnt by their mistakes and made any changes needed to avoid them happening again.