Domiciliary Care Experts

The service provided domiciliary care and support to people and supported some people with complex care needs. The service was registered to provide nursing support to people. However, at the time of the inspection there were no nurses working at the service and staff were not providing nursing support. At the time of this assessment there were 63 people (a mixture of adults and children) receiving support with ‘personal care’: help with tasks related to personal hygiene and eating. Not everyone using the service receives the regulated activity of personal care. Where they do, we also take into account any wider social care provided. We did not review people’s care and support who did not receive personal care.

This service is registered to support people with physical disabilities, autistic people and people with a learning disability. ‘Right support, right care, right culture’ (RSRCRC) is the guidance 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. We have assessed the service against ‘Right support, right care, right culture (RSRCRC)’ 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.

During the assessment we found 7 breaches of the regulations in relation to person centred care, consent to care and treatment, safe care and treatment, complaints management, staffing, fit and proper persons employed and good governance. The breaches of safe care and treatment, staffing and good governance were continued breaches from the previous assessment. People continued to be placed at risk of harm. The oversight and management of the service had not improved.

People were not always protected from avoidable harm because risk assessments were not always in place, and not always clear, comprehensive and up to date. Care plans were inconsistent. Some were very detailed to give staff clear information on how to meet people’s needs and some were sparse. Some people were not always treated with dignity and respect. Medicines were not always well managed. Systems and processes to audit and check the service were not in place. Staff felt communication was not always effective. Staff were supported through training; however, staff had not all completed training relevant to people’s assessed needs. Staff had not always been adequately deployed at times that met people’s needs, they did not always have sufficient travel time between people they supported. Staff had not always been recruited safely. However, the provider had carried out relevant checks such as criminal record checks before staff started as well as carrying out home office right to work in the UK checks.

This service remains 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 user our enforcement powers in response to inadequate care and provide a timeframe within which providers must improve the quality of the care they provide.

In instances where CQC have decided to take civil or criminal enforcement action against a provider, we will publish this information on our website after any representations and/ or appeals have been concluded.