Sparrow Health Care Ltd

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 Care Quality Commission (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. The provider was not fully aware of this guidance and had not ensured it was known to staff and embedded into practice.

Risks to people were not always fully assessed, and risk assessments were not consistently completed or detailed. Medicines were not always managed safely, and staff did not always complete records in relation to medicines administration and recording. Accidents and incidents were not always reported in detail and were not used to inform learning. Safeguarding concerns were not reported in line with guidelines and information requested to support safeguarding investigations was not provided in a timely manner.

Staff were not recruited safely as checks on their suitability and eligibility to work in the UK had not always been completed. Records to confirm staff had received a full induction, training and supervision were not maintained.

The provider’s governance systems had not been effective in identifying or addressing the areas for improvement we found during this assessment. The provider did not complete audits of the service and had not implemented an action plan to address shortfalls they were aware of. The provider told us they had recognised the need to expand the management team to ensure better oversight of the service. Staff had been recruited into senior positions although had not fully established how their roles would work together.

The service was in breach of 5 legal regulations in relation to safe care and treatment, safeguarding service users from abuse and improper treatment, good governance, staffing and safe recruitment. Following the inspection we issued warning notices highlighting the improvements the provider needed to make in relation to safe recruitment systems and governance. We have also asked the provider for an action plan in response to the concerns found at this assessment.

Despite these concerns, people and their relatives told us they were very happy with the service they received and felt they were supported well. There was evidence of other professionals being involved in people’s care and support. Staff told us they were supported by the provider and felt the provider was approachable and open in their approach.