Fountain Based Ltd

Updated 1 September 2022

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 carried out by one inspector.

Service and service type

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

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

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 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 14 June 2022 and ended on 15 July 2022. We visited the location’s office/service on 14 June 2022.

What we did before the inspection

We reviewed information we held received about the service. We sought feedback from the local authority and professionals who might work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with one person and one relative of people who used the service about their experience of the care provided. We also spoke with two professionals who worked alongside the service. We spoke with the registered manager, who was also one of the directors for the provider, and one care worker for the service. We reviewed a range of records. This included two people’s care records. We looked at two staff files in relation to recruitment. We also looked at a variety of records relating to the management of the service.

We continued to seek clarification from the provider to validate evidence found. We looked at further evidence sent to us by the registered manager regarding training, quality assurance and working with other agencies.

Updated 1 September 2022

About the service

Fountain Based Ltd is a domiciliary care agency registered to provide personal care. At the time of the inspection, two people were receiving support with personal care.

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

Risks to people were not always recorded or mitigated against. Wording in documentation around risk was imprecise and would not provide staff with suitable instruction to ensure risks were understood and met. Recruitment processes were not robust. The provider had not completed checks on new staff correctly to ensure they were safe to work with vulnerable people. The provider was unaware of up to date guidance on infection prevention and control and did not record staff testing satisfactorily. At the time of inspection no one was being supported to have their medicines administered; however, we have made a recommendation about assessing medicine risks because staff had recorded the medicines people take.

Staff were trained to safeguard adults from abuse and there had been no incidents or accidents at the service.

The provider did not have good oversight of staff training and induction of staff appeared incomplete.

Assessments of people’s needs had been completed with people in line with the law. The service recorded people’s care in communication logs. People’s nutrition and hydration needs were met. People consented to their own care and staff understood the law in this regard.

Some of the language used in care plans was not respectful of equality or diversity.

People and relatives told us staff treated people well. People were able to make their views known to the service. People’s privacy and dignity were respected and their independence promoted.

Care plans were not always person-centred; language used in care plans did not always treat people as individuals or reflect their needs.

People’s end of life wishes were not recorded. We have made a recommendation about this.

The service met and recorded people’s communication needs. People and relatives told us they would feel comfortable to complain if required.

Quality assurance systems and processes at the service were not effective. Language used in documentation was not always up to date or correct.

Staff were clear about their roles. Management were able to tell us how they would respond if things went wrong. The service sought to work with other agencies to the benefit of others.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 19 October 2018 and this is the first inspection.

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.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to recording risk, recruitment, staffing and also governance at this inspection.

We have made two recommendation to the provider. We have recommended they follow best practice guidance around managing medicines safely and recording end of life wishes.

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

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.