UK Top Care Ltd

Updated 1 September 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.

This was a targeted inspection to check whether the provider had met the requirements of the Warning Notices we issued in relation to Regulation 18 (Staffing) and Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We had concerns we had about the ability of staff being able to provide safe care and the lack of management oversight of risk.

Inspection team

This inspection was carried out by 1 inspector.

Service and service type

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

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 24 hours notice of the inspection. This was because it is a small service and we needed to be sure that the registered manager would be in the office to support the inspection. We also gave time for the registered manager to send us inspection information, so we did not have to spend an extended amount of time in the office of the service.

Inspection activity started on 21 June and ended 22 June 2023. We visited the office location on 21 June 2023.

What we did before the inspection

We reviewed information we had received about the service and we sought feedback from the local authority.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We spoke with 1 person who used the service about their experience of the care provided and 4 relatives. We spoke with 3 care staff and the registered manager. We reviewed a range of records. This included 3 care records. We looked at 3 staff files in relation to staff supervision and training. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

We continued to seek clarification from the registered manager to validate evidence found, which was sent to us.

Updated 1 September 2023

About the service

UK Top Care Ltd is a domiciliary care agency providing personal care and support to people in their own homes. 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. At the time of our inspection there were 6 adults who received packages of support which included personal care.Systems to assess, monitor and improve the quality of the service were not always effective. This included oversight of people's care records, staff training and competency. Quality assurance checks took place in some of these areas but these were not consistent they did not identify the issues we found during this inspection.

There was a continued lack of effective leadership. The provider’s business continuity plan did not include management contingency plans in the event the registered manager was absent. We found the service was managed by the administrative staff member with limited relevant management experience and knowledge of working in social care whilst the registered manager was on holiday.

Staff had not received induction and essential training in all key areas of care provision to help ensure they had the skills and knowledge to fulfil their roles. There was no system to support and supervise staff and to ensure staff were kept up to date about changes to people’s needs or practices. Whilst we found no evidence people

People’s experience of using this service and what we found

were harmed, they remained at risk because staff were not trained.

People and relatives told us they felt safe with the staff and the care provided. The provider understood their role to act on abuse and report it to relevant external agencies but further action was needed to ensure all staff were trained in this area.

Risks to people's safety were assessed and measures were put in place to reduce any risks.

People were supported with medicines administration and care plans detailed the level of support when this was required. Further action was needed to ensure all staff were trained to support people with medicines.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; and policies were in place to support this practice. We have made a recommendation about the principles of the Mental Capacity Act.

There were sufficient numbers of staff who had been safely recruited to meet people's needs.

People and relatives told us staff always used PPE to protect them from risk of infectious diseases. Systems were in place to control and prevent the spread of infection.

Rating at last inspection and update

The last rating for this service was requires improvement (published 11 December 2019). 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 the provider remained in breach of regulations.

Why we inspected

We carried out an announced focused inspection of this service from 6 to 14 November 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 safe care and treatment and governance. This inspection was in part prompted by a review of the information we held about this service.

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 and well-led which contain those requirements.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this report.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for UK Top Care Ltd on our website at www.cqc.org.uk

Enforcement and Recommendations

We have identified continued breaches in relation to staffing and governance oversight systems at this inspection. We issued 2 warning notices, which required the provider must make improvements to meet the regulations.

This report only covers our findings in relation to the Key Questions; Safe and Well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor the provider's progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.