Background to this inspection
Updated
28 November 2020
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 Care Act 2014.
Inspection team
The inspection was carried out by one inspector. An Expert by experience carried out telephone calls to people using the service and relatives on 5 November 2020. 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.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because we needed to ensure the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with the registered manager, deputy manager, quality compliance officer and human resources and training manager. Following the inspection, the Expert by Experience contacted eight people who were using the service and five relatives of people receiving support. We also contacted 111 staff who worked for service to gain their feedback. These staff included care workers, office-based staff and an occupational therapist. Feedback was received from 44 staff.
We reviewed a range of records during this inspection. This included four care plans and multiple medication administration records. We looked at the recruitment records for three staff members. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We requested additional information in relation to visit rotas and infection control. We also received feedback about the service from three health and social care professionals.
Updated
28 November 2020
About the service
Specialist Care Services Limited is a domiciliary care agency. It provides personal care to mostly older people living in their own homes in the London Borough of Hillingdon. It also supports some adults who are living with dementia and adults who have physical or learning disabilities. At the time of our inspection the service was providing care and support to 141 people.
Not everyone using the service receives personal care. CQC only inspects the service being received by people provided with ‘personal care’, that is, help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.
People’s experience of using this service and what we found.
People told us they felt safe when receiving care. Care workers were assessed as competent to administer people’s medicines. The provider had processes in place for the recording and investigation of incidents and accidents, safeguarding and complaints.
Risk management plans had been developed which provided care workers with guidance on how to minimise risks in relation to health and wellbeing for people using the service.
The provider had safe recruitment practices in place. There were enough care workers allocated to each visit to provide the support people needed.
Care plans described the care and support a person required and how they wanted it to be provided.
People using the service were supported to maintain links with their family and community to reduce the risk of social isolation.
The provider had a complaints process in place and people told us they knew what to do if they wished to raise any concerns.
There was a range of quality assurance processes in place to identify if any actions were required to improve the service. People using the service and staff felt the service was well-led.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvements (published 31 May 2019) and there were three breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an announced comprehensive inspection of this service on 26 and 27 March 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve person centred care, safe care and treatment and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Specialist Care Services on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.