SQ Carers Ltd

The assessment was prompted in part by information of concern we received about the quality-of-care people received and the management of the service. This assessment examined those potential risks. This was a comprehensive inspection, and we reviewed the ratings for all key questions.

This inspection found systems for identifying, capturing and managing organisational risks and issues was not effective. Operational concerns were not always addressed and resolved in a timely way, for example, each missed or late care call was not fully investigated, so any emerging issues went unknown. People and relatives told us their care calls were not always when they needed, often causing them some issues. Staff did not always promote people’s privacy and dignity, and staff were not always sufficiently trained to understand people’s health needs. We found breaches of 3 legal regulations for good governance, person centred care and safe and effective staffing.

Risks to people’s wellbeing and safety were assessed, however some care records were conflicting in detail, with staff completing care information and reviews with limited knowledge of the person. People and families were not always involved in how their care was reviewed and received.

Most people were able to administer their medicines themselves or with family support. Where staff administered people’s medicines, some of those medicines were not always administered in line with guidance. Where care calls took place later than planned times, for those people, this could have an impact on their overall health and welfare.

Consent and agreement to certain practices was not always well thought through, especially when the provider outsourced some of their work to an external business. The provider had recruitment processes, but we found staff were not always recruited safely. We could not be confident; all safeguarding concerns were referred to appropriate agencies. There was evidence the provider worked alongside other health professionals, but records did not always evidence, staff followed the advice.

During our visit it was problematic getting the information we needed because it was sometimes on systems that could not be accessed by the provider. Following our visit, we sent the provider a formal request, asking for information we needed to help form our evidence and judgements. Despite receiving a response, some of the information requested was not provided and other information was unclear. Some telephone numbers for people we were given to call for their feedback, meant, they could not be reached, and we could not speak with all the staff we wanted to, as some of our calls were not returned. Therefore, we have made our judgements and ratings based on the evidence we hold.