Background to this inspection
Updated
1 March 2023
The inspection
We carried out this performance review and assessment under Section 46 of the Health and Social Care Act 2008 (the Act). We checked whether the provider was meeting the legal requirements of the regulations associated with the Act and looked at the quality of the service to provide a rating.
Unlike our standard approach to assessing performance, we did not physically visit the office of the location. This is a new approach we have introduced to reviewing and assessing performance of some care at home providers. Instead of visiting the office location we use technology such as electronic file sharing and phone calls to engage with people using the service and staff.
Inspection team
The inspection was carried out by 1 inspector and an Expert 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 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 72 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection. Inspection activity started on 30 January 2023 and ended on 6 February 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection and we sought feedback from the local authority 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 all this information to plan our inspection.
During the inspection
This performance review and assessment was carried out without a visit to the location’s office. We used technology such as telephone calls to enable us to engage with people using the service and staff, and electronic file sharing to enable us to review documentation. We reviewed 4 care records, 4 medicines records, 3 recruitment and a range of records relating to the management of the service. We spoke with 2 people and 6 relatives. We spoke with 6 staff, including the provider, registered manager and care staff.
Updated
1 March 2023
About the service
Personal Assist is a domiciliary care agency, providing personal care to people in their own homes or flats. At the time of the inspection 26 people were 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. At the time of the inspection 17 people were receiving care.
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
Care plans were person centred, however did not always contain enough information about how to support people with their communication or sensory needs. The registered manager did not have sufficient knowledge about how to provide quality care for people who have a learning disability and staff did not have appropriate training in this area. However, people and relatives told us they received the right support from staff. Risks to people were assessed and people were protected from the risk of unsafe care and harm.
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.
Right Care
The service had recently undergone some staffing and recruitment issues, which meant at times staff were late for calls. The provider had recognised these concerns and had taken action to address them, to improves people’s support. People and their relatives told us they felt safe and staff were competent and kind. Accidents and incidents were monitored, and notifiable incidents were reported to external agencies where required.
Right Culture
Effective governance and quality assurance systems were not in place to drive improvements in the service. People and relatives told us there was a lack of leadership. Complaints were dealt with in a timely manner, with actions arising to learn lessons from these. Staff told us they felt able to raise concerns and were supported in their roles.
Systems and processes were in place to protect people from the risk of avoidable harm. Staff were trained and knowledgeable about how to spot signs of suspected abuse and how to raise concerns. Safeguarding concerns were investigated and reported to external agencies where required. Staff received training in relation to infection, prevention and control and people told us staff followed guidance and wore personal protective equipment, to help prevent the spread of infection. People received their medicines as prescribed.
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 6 November 2018).
Why we inspected
We received concerns in relation to staffing, training and leadership. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
We have found evidence that the provider needs to make improvements. Please see the well led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Personal Assist on our website at www.cqc.org.uk.
Recommendations
We have made a recommendation the provider implements staff training and reviews there records regarding supporting people with a learning disability.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and video and phone calls to engage with people using the service as part of this performance review and assessment.