Standards Care Limited

Updated 22 June 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 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 service is required to have a registered manager. A registered manager is a person who has registered with CQC 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 not a registered manager in post. The previous registered manager had de-registered with CQC, however they continued to work at the service overseeing recruitment, training and staffing allocation. An interim manager was in place who was applying to be registered with CQC. They will be referred to as “the manager” in this report.

Notice of inspection

We gave the short 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 22 March 2022 and ended on 7 April 2022. We visited the location’s office on 22 March.

What we did before inspection

We reviewed information we had received about the service since the last inspection. 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 all this information to plan our inspection.

During the inspection

We spoke with three people's relatives. We spoke with three care workers, who were the main care workers for the three people receiving care, the manager, the business development manager and previous manager.

We reviewed a range of records. These included three people's care records and medication records. We looked at three 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 22 June 2022

About the service

Standards Care Limited is a domiciliary care service providing personal care to people in their own homes. The service provides support to people with physical disabilities, mental health or learning disabilities who need support with everyday activities. At the time of our inspection there were three people using the service.

Not everyone who used the service received personal care. The Care Quality Commission (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.

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

Though some improvements had been made, significant issues remained in assessing and managing risks to people’s health, safety and wellbeing. Medicines were not managed safely. Recruitment procedures were not robust to ensure staff were appropriate to work with people. Some incidents were reported and investigated robustly, this appeared to have improved.

People were not always supported to have maximum choice and control of their lives and the provider did not ensure staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Best practice and expected standards were not always followed in assessing and planning to meet people’s needs. Risks related to people’s eating and drinking were not always assessed, though people’s relatives told us that people were supported to eat and drink enough.

People’s relatives told us that, though there had been unkind staff in the past, the current staff caring for their loved ones were professional and compassionate. Staff we spoke with were passionate about their work and clearly cared for people.

Improvements had been made in managing complaints, which had been an issue on the previous inspection. Staff we spoke with knew people well and understood their preferences, religious and spiritual needs.

Though we had positive feedback about improvements in the change in management, there remained significant issues with the service which had not been resolved since the last inspection. The new manager has created a quality improvement plan after the inspection, and has sent evidence of actions taken after the inspection.

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 22 March 2021). The service remains rated requires improvement.

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 carried out to follow up on action we told the provider to take at the last inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this report.

Enforcement

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. Complete/delete as appropriate. 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 safe care and treatment; need for consent; staffing; fit and proper persons employed and good governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.