Sublime Care

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

During our assessment of this key question, we found the provider had failed to effectively assess, manage, monitor and improve the quality and safety of the service, which was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. There were quality assurance process in place but these were not always effective and not identified/resolved all the issues we found staff files, care plans and risk assessments, medicine records and ECM records. The provider has told us how they will make improvements in some of these areas but we could not be assured they always understood how to make all the necessary improvements for the shortfalls we found. You can find more details of our concerns in the evidence category findings below.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Capable, compassionate and inclusive leaders during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Staff confirmed there were process in place to monitor staff performance. Comments from staff included, “They always come to the clients house and do spot checks” and “I don’t have any concerns. I think the management are doing great.” Despite the positive feedback from staff we were not assured by the provider’s responses when we shared our concerns about some of the provider’s quality assurance processes and they did not provide sufficient assurance they would make all the necessary improvements.

There was a process in place to gather feedback from people and routinely check on the quality of care being delivered. However, quality assurance processes had not identified all the issues we found with care plans, risk assessments and medicines. When we raised this with the provider they did not provide sufficient assurance they would address all the issues we found. The provider had identified some of the issues with the ECM and had acknowledged further improvements were required to ensure the system was safe and effective. The failure to assess, monitor and improve the quality and safety of the service effectively was a breach of Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The registered manager and other senior staff conducted spot checks to monitor staff performance.

Most people and their relatives told us the provider communicated well and kept them informed of all necessary information. Comments from people included, “There is good communication with the team in the office and they keep me informed whilst I am away of any issues that may occur” and “I talk to the manager sometimes, she’s easy to speak to.”

Staff told us they worked with other health and social care professionals when required. One member of staff told us, “The office will contact the district nurse if there are any issues with skin.” We found some good examples of working in partnership and communicating with other professionals. However, the failure to share concerns related with fire safety meant we could not be assured the provider always worked in partnership with relevant external partners. Care plans did not always contain sufficient information about relevant stakeholders. 1 person was being supported by a live-in carer which meant care tasks were carried out with staff from another care provider. The person’s care plan did not contain any information about the organisation providing the live-in care or any details about who to contact in the event of an emergency.

We received positive feedback from the local authority commissioners about how the provider worked with external partners. One professional told us, “The registered manager runs a tight ship and they will make necessary referrals to other professionals when required” and “The registered manager shared a recent newspaper article which highlighted examples of homecare agencies providing as little as 3 and a half minutes of care to people who required 30 or 45 minutes. The article sheds light on a disconcerting situation wherein a dementia home care agency allegedly allocated insufficient time to taxpayer-funded care visits, despite making claims of providing extensive care.”

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.