Domiciliary Care Croydon

Updated 3 February 2023

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

This inspection was undertaken by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 6 December 2022 and ended on 19 December 2022. We visited the location’s office on 6 December 2022.

What we did before the inspection

We looked at all the information we held about the provider, which included information they provided us when they were registered. We 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 sought feedback from the local authority who work with the service. We used all this information to plan our inspection.

During the inspection

We spoke with 6 people and 3 relatives of people who used the service about their experience of the care provided. We spoke with 5 members of staff, including the registered manager, office manager and care staff. We reviewed a range of records, this included 6 people's care records and 4 staff files in relation to recruitment and supervision. A variety of records relating to the management of the service, including duty rota’s and policies and procedures were reviewed.

Updated 3 February 2023

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 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.

About the service

Supported Living is a domiciliary care agency providing support to people in their own homes. At the time of our inspection there were 38 people receiving support mainly in and around the Brighton area. Not everyone who used the service received 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

Right Support:

People were not always supported to have maximum choice and control of their lives. Some people reported staff were rushed and did not have the time to help support people with their independence. Although staff had received training in the mental capacity act and other related guidance, people told us some staff were not always offering choice or giving people control over their care and support.

We have made a recommendation for the provider to consult the Mental Capacity Act and other related guidance.

Right Care:

Staff did not always understand people’s cultural needs. People told us they found some staff were inexperienced and were not aware of how to undertake basic tasks such as cooking and cleaning. The provider had failed to support staff with the knowledge and skills they needed to provide people with culturally appropriate care. Staff told us they would protect people from poor care and abuse but were unsure about recognising the signs of abuse and how to report concerns outside of the organisation. Although the provider told us they had enough staff to keep people safe, people told us staff were often late and sometimes did not turn up. People told us when this happened they did not always feel safe because this had an impact on their care and support. People’s care plans were not always person centred and some risks had not been identified, this meant staff may not have the information they needed to care and support people appropriately.

Right Culture:

People told us they sometimes had problems speaking to a manager when they had concerns. Some people felt when they did raise concerns they were not listened to because things did not improve. Staff turnover had been high. The provider was recruiting new staff but this meant there was a lack of consistent care. Those people who had the same care staff visit them were happy with the care and support provided. However, the majority of people told us they did not know who would be supporting them or when they would be coming and this had a negative impact on their care. The provider had started to make improvements in this area and felt they would be able to improve staff punctuality and keep the same team of care staff with the same people to help with continuity of care. People did not always feel involved in planning their care. People told us they had received a visit at first to go over their care and support needs but information about their ongoing care and support was sometimes missing so they were unable to refer to this when they needed to. The provider had been working with the local authority to make changes to help improve people’s care and support.

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 3 August 2021 and this was the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about late and missed calls by staff and concerns about the care and support people received. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements in each key question.

The provider has been working with the local authority to make improvements to the service and had an action plan in place to monitor progress in identified areas. When we highlighted areas of concern during our inspection the provider gave assurances these would be addressed to reduce risk to people receiving care and support.

Please see the action we have told the provider to take at the end of this report.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, safeguarding people at risk of abuse, person centred care, staffing and good governance.

Please see the action we have told the provider to take at the end of this report.

We have made a recommendation in relation to staff understanding of consent within the Mental Capacity Act 2005 and other relevant guidance.

Follow up

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