Impeccable Healthcare Services Limited

Updated 22 August 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 26 June 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in. Inspection site visit activity was on 26 June 2018 which included a visit to the office location to see the manager and office staff; and to review care records, staff files and other records used in managing the service such as policies and procedures. On 6 July 2018 an expert by experience made calls to people on the telephone whilst they were in their homes. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

The inspection team consisted of a single inspector and an expert by experience. Prior to the inspection we reviewed information we held about the service including notifications we had received. Notifications are information about important events the provider is required to tell us about by law. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We contacted the local authority that commissioned services from the provider to obtain their views about the service. Information acquired was used to help us plan our inspection.

We spoke with two people and six relatives. We also spoke with six staff members including the registered manager, an office administrator and four care workers. We reviewed four care files including care plans and risk assessments. We looked at five staff files which included recruitment checks, supervisions and appraisals. We also looked at other records used in managing the service and this included policies and procedures, accidents and incidents, minutes of meetings, audits and complaints logs.

Updated 22 August 2018

This inspection took place on 26 June 2018 and was announced. Impeccable Healthcare Services Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults, at the time of this inspection, 14 people were using the service.

At our comprehensive inspection on 30 and 31 May 2017, we found breaches of regulations as appropriate systems were not always in place to ensure that people’s medicines were managed safely, adequate management plans were not developed to ensure risks were managed safely, and the quality of the service was not effectively monitored and assessed. Following that inspection, the provider wrote to tell us the actions they would take to address our concerns. At this inspection we found that the provider had completed these actions and complied with the regulations.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People’s medicines were now managed safely. People were given their medicines as prescribed by healthcare professionals and the support people required to take their medicines was documented in their care plans. Staff had completed medicines training and their competency had been checked to ensure they had appropriate knowledge and skills to support people manage their medicines safely.

People were now protected from avoidable harm because risks to people had been identified, assessed and had appropriate management plans in place. The provider now had appropriate systems in place to assess and monitor the quality of the service including regular visits to people’s homes and audits. The provider had implemented an electronic call monitoring system which was used to monitor staff attendance and to ensure people’s needs were met.

The provider had policies and procedures in place to protect people from the risk of abuse and staff knew of actions to take if they had any concerns of abuse by reporting and recording it. The provider followed safe recruitment practices to reduce the risk of unsuitable staff working at the service. There were appropriate numbers of staff available and deployed to ensure people’s needs were met. People were protected from the risk of infection because staff followed appropriate infection control protocols such as washing of hands to prevent the spread of diseases. Where accident or incidents occurred, this was reported and recorded appropriately to drive service improvement.

Before people started using the service, their needs were assessed to ensure they would be met. Where required healthcare professionals were involved in these assessments to ensure they adhered to best practices. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported to have good health, to eat and drink sufficient amounts for their wellbeing and access healthcare services where required. The provider worked in partnership with other health and social care services to ensure people had adequate support when moving between services or using multiple services. Staff were supported through induction training and supervision to ensure they had the knowledge and skills required to perform their roles.

People were supported by staff that were kind and caring. People were given choices and were involved in making decisions about how they would like to be supported. People’s privacy and dignity was respected and their independence promoted. People’s needs were met because staff followed the guidance in their care plan. Staff understood the requirement of the Equality Act and supported people without discrimination. People were supported to participate in activities that interest them.

The provider had a complaint policy in place which provided information to people and their relatives on how to make a complaint. Complaints were addressed in line with the provider’s procedures to ensure people were satisfied with the service. Where required people were supported at their end of their life. People’s communication had been assessed and information was presented in formats that supported their understanding.

The provider had an effective out-of-hours system which people, their relatives and staff used to contact the management team in the event of an emergency. People’s views were gathered through annual surveys, telephone monitoring checks and homes visits to improve on the quality of the service. The provider worked in partnership with key organisations such as the local authority to provide an effective service. There were systems in place to support continuous learning and improve the quality of the service.

The provider worked within the requirements of the Health and Social Care Act 2008 (Regulated Activates) Regulations 2014 and submitted notifications of significant events at the service. The provider had displayed their CQC rating both at their office location and on their website. Staff were happy working at the service and felt supported in their role. Regular team meetings were held to provide updates, training and gather feedback to improve on the service.