Plus Point Care Ltd

This was an announced assessment because the service was small, and we needed to ensure the Provider would be available to support the assessment.

Plus Point Care Ltd have not had an assessment since they were registered with CQC. This assessment had planned to look at all quality statements within all key questions. However, due to a lack of information provided, we were unable to assess the key questions of Caring and Responsive. At this assessment Plus Point Care Ltd was rated inadequate.

Whilst people who received care told us they were generally happy with the care they received, and the feedback from staff was positive, we identified significant concerns with the governance of the service, and the safety of people being supported by Plus Point Care Ltd.

This assessment resulted in 2 breaches. The provider was in breach of the legal regulation relating to safe care and treatment of the people they supported. They were also in breach of the legal regulation in relation to the governance of the service.

We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted. The manager told us they were aware of this guidance but were unable to explain it and did not demonstrate the principles of ‘Right support, right care, right culture’ when supporting people.

Right Support:

The registered manager was asked if anyone they support had a learning disability – one of the people identified was reported as having a “disability, but not a learning disability.” The care plan stated within the medical history the person did have a learning disability, which showed the registered manager was unable to identify all people who required the support outlined in this guidance. With only 12 people receiving support, the registered manager would be expected to have oversight of this specialist requirement for tailored support.

Whilst staff said they supported people to access community activities, and community access was listed in a person’s care plan, there was no detail in the care plan to guide staff how best to support the person in this setting. This meant we could not be assured the individual needs of people had been adequately addressed.

The provider had not ensured staff had received appropriate training for their role. This included not addressing their own training needs.

Whilst staff told us they knew how to escalate safeguarding concerns, training records provided showed not all staff had received this essential training.

People told us there were sometimes delays in care calls and oversight of staff deployment was not adequate.

Right Care:

People told us they were treated with kindness by staff. We heard staff gave care that was dignified. As the Provider did not give us all care plans and risk assessments we requested, we were unable to be assured care plans were in place that enabled staff to provide person centred, outcome focussed, and safe care for each person. In addition, we were unable to assess whether people’s preferred communication styles were known and if staff could therefore support people in the way they preferred.

We were told easy read formats of documents were available, however these were not provided as was requested.

Right Culture:

People, their relatives and staff told us their views and feedback was respected and acted on. However, when documented feedback had been received, the lack of governance processes meant we were unable to be assured of the timeframes of feedback, and the actions taken.

The Provider did not lead by example; they did not consistently act with openness and transparency and failed to engage with all external stakeholders. This meant the culture could not be assured at all levels of Plus Point Care Ltd.

The registered manager undertook a range of audits to check on the quality of care provided; however, action was not always taken when concerns were identified.

In instances where CQC has begun a process of regulatory action, we may publish this information on our website after any representations and/or appeals have been concluded, if the action has been taken forward.

This service is being placed in special measures. The purpose of special measures is to ensure that services providing inadequate care make significant improvements. Special measures provide a framework within which we use our enforcement powers in response to inadequate care and provide a timeframe within which providers must improve the quality of the care they provide.