KE 247 Support Services

Updated 10 May 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 two inspectors.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats including five ‘supported living’ settings so those people can live as independently as possible. People’s care and housing are 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 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

This inspection was announced. We gave the service 48 hours’ notice of our visits. This was because it is a small service and we needed to be sure that the registered manager would be available to support the inspection. Inspection activity started on 11 March 2022 and ended on 16 March 2022. We visited the office location on 11 and 16 March 2022.

What we did before the inspection

We reviewed information we had received about the service since it registered with us. We gathered feedback from the local authority and Clinical Commissioning Group (CCG) who funded the care provided. We also 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 of this information to plan our inspection.

During the inspection

We spoke with one person and three people’s relatives via the telephone to gather their experiences of the care and support provided. We spoke with the registered manager, the administrator and three support workers. We reviewed a range of records. This included three people's care records, staff training information, three staff recruitment records, and records of the checks the registered manager completed to assure themselves people received a safe and good quality service.

After the inspection

We spoke with the registered manager and received information from them to validate the evidence we found. We gathered further feedback from the local authority and spoke with a health professional who was involved in one person’s care.

Updated 10 May 2022

About the service

KE 247 Support Services is a domiciliary care agency which is registered to provide personal care and support to people in their own homes including people living in supported living settings. The service is registered to provide support to children, adults under the age of 65 years, adults over 65 years, people with learning disabilities, people with mental health conditions and people with sensory impairments.

At the time of our inspection the service was supporting 10 people. Four of those people were in receipt of 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.

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

Governance systems to monitor the quality and safety of the service needed to be improved and managerial oversight of the care and support provided needed to be strengthened to demonstrate good quality safe care was always provided. At the time of our visit a new care services manager was being recruited to address this.

Some information we requested was not easily accessible during our visits and completed audits and checks had not identified the shortfalls we found. That meant opportunities to drive forward improvement had been missed. In addition, the system to ensure CQC were notified of all significant events that happened was not always effective. Action was taken to address this.

Whilst one person told us they felt safe with their support workers and three relatives felt their family members were safe, risk management required improvement. People’s needs had been assessed before they started to use the service. However, known risks associated with people’s care and support were not always assessed and risk management plans did not always have important information to help staff provide safe care. Despite our findings staff understood how to keep people safe. The registered manager told us they would take action to improve safety.

Staff had been recruited safely and enough staff were employed to meet people’s needs. Staff had completed safeguarding training and policies and processes were in place to safeguard people from the risk of harm.

Staff followed safe infection prevention practice in people’s homes and confirmed Personal Protective equipment (PPE) was available for them to use to control and prevent the spread of infection. However, risks associated with COVID-19 had not always been assessed in line with guidance.

The management of medicines required improvement. Whilst most people’s medicine records showed people had received their medicines as prescribed, national medicines guidance was not always followed and checks of medicines needed to be strengthened to ensure they were effective. The registered manager told us this would be addressed.

People were supported to have maximum choice and control of their lives and staff did supported

them in the least restrictive way possible and in their best interests. However, the policies and systems in the service did not support this practice.

Staff knew what people liked to eat and drink, and the registered manager and staff provided examples of how working with health professionals had benefited people. Overall, relatives provided positive feedback about the staff and told us the care and support provided was effective. Staff enjoyed their jobs and spoke positively about their induction and the training they had completed. The registered manager and the staff team understood the importance of treating people equally. People were respected, and people's privacy and dignity were maintained.

Relatives were involved in their family members care and felt the service was responsive. Whilst staff knew people well more information needed to be added to some care records to help staff provide personalised care. Staff understood how to communicate with people but the Accessible Information Standard (AIS) had not been fully considered during care planning.

The registered manager demonstrated commitment to learning lessons and understood their responsibility to be open and honest when things had gone wrong.

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 07 May 2020 and this is the first inspection.

Why we inspected

This was a planned inspection of this newly registered service.

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. We will continue to monitor the service and 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 two breaches of the regulations in relation to safety and governance and have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the registered manager 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.