Shining Care Ltd

Shining Care is a domiciliary care agency providing support and personal care to people in their own homes. The service provides support to adults who have a range of physical, cognitive, or mental health needs. At the time of the inspection, the provider told us 50 people were receiving support with personal care from the service.

Not everyone who used the service received personal care. Care Quality Commission (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

People were not always protected from the risk of abuse. Systems and processes had failed to ensure incidents of alleged abuse or harm were identified, reported, or investigated thoroughly and in a timely way.

Governance and accountability arrangements were not always clear and quality assurance systems were not effective enough to assess risk and performance and improve the quality of the service. Some audits were in place, but these were not comprehensive enough to identify and manage risks and improvements.

We received reports of a high number of missed or late visits. The people we spoke with told us staff usually arrived on time and as expected. We saw data which suggested staff were arriving for visits later than scheduled, however it also appeared the electronic recording system was not being consistently used by staff or checked by managers.

Systems to identify and address safety concerns were in place, but these were not used consistently enough to manage and reduce safety concerns, incidents and near misses.

Medicines records consistently needed to follow best practice guidance. We made a recommendation to the provider about the management of medicines.

Professionals found communication with the provider was not effective. We made a recommendation about communication to the provider. Relatives told us they were happy with the communication from staff at all levels.

People who used the service gave positive feedback in the surveys we saw. The people we spoke with were positive about the staff who supported them and the service overall.

The management team was well established and committed to providing a quality service. Staff were positive about working for the organisation and felt supported and valued in their roles.

Risk assessments were in place, up to date and regularly reviewed. 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; the policies and systems in the service supported this practice.

We were assured that people were protected by the prevention and control of infection. Staff had access to personal protective equipment (PPE) as required, such as face masks, disposable gloves, and aprons.

The management team were keen to work with the wider community and other stakeholders to ensure people they supported were well represented and heard.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 10 June 2021).

Why we inspected

The inspection was prompted in part due to concerns received about safeguarding, staff knowledge and skills, management oversight and standards of the service provided. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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 changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of the full report. You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement and Recommendations

We have identified breaches in relation to safeguarding people from the risk of abuse and ensuring management and governance arrangements are robust.

We have made recommendations relating to the safe management of medicines and effective communication with all groups.

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

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.

About the service

Shining Care Ltd is a domiciliary care agency. It provides support to people who live in their own homes. At the time of the inspection, the service was providing support to 45 people.

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

Risk assessments were in place, complete and up to date. Information included what staff should do to manage risks and ensure people were safe. Risk assessments were available to staff on an application on their mobile phone. This meant they always had up to date guidance about how they should support people safely and reduce risk.

People felt safe with the staff who supported them and talked positively about staff. Staff received training and understood their responsibilities.

Medicines administration records were available electronically to staff, and these were completed accurately. Staff were trained in the safe management of medicines, and competency spot checks were carried out regularly.

We were assured that people were protected by the prevention and control of infection.

People were positive about the service they received. They received personalised care which met their needs. Staff told us they enjoyed supporting people and were proud to work for the organisation.

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; the policies and systems in the service supported this practice.

Managers were available and staff and people who used the service were confident in raising concerns and making suggestions about the service.

Standards and performance were monitored, and improvements made where necessary. Audits and checks were carried out and these supported staff to provide high quality 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 and update

The last rating for this service was requires improvement (published 10 April 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 improvements had been made and the provider was no longer in breach of these regulations. However, we found there was a new breach of regulations. You can see what action we have asked the provider to take at the end of this full report.

Why we inspected

We carried out an announced inspection of this service in March 2019. Breaches of legal requirements were found.

We undertook this focused inspection to check the provider had followed their plan to improve 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.

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 remained requires improvement. 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 Shining Care Ltd 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. We will continue to work alongside the provider and local authority. If we receive any concerning information we may inspect sooner.

People’s experience of using this service: People were happy with the care they received. This was reflected in both the comments we heard and from the provider’s own monitoring of the service. However, systems in place to support the running of the service were not sufficient and work needed to be done to improve both record keeping and the management of risk associated with people’s care. Individual risk assessments were not dated and so it was not possible to see how up to date they were and whether they reflected people’s current needs. In some cases, sections of the assessment were missing or the measures in place to manage risk were unclear.

Staff and people using the service were all positive about the management of the service and felt their concerns would be listened to. Staff confirmed they were spot checked as part of managing their performance. There was some evidence of quality monitoring, however this needed to be developed further and the service were working with the local authority to achieve this. Systems for filing and recording information were chaotic and this needed to be addressed in order to support the smooth running of the service.

Rating at last inspection: Our last inspection took place in December 2017 and the service was rated Good at this time. This inspection was focused on safe and well-led and we rated each of these domains as Requires Improvement.

Why we inspected: This was a focused inspection based on intelligence we held about the service. The information raised concern about how safe people were and how well led the service was.

Enforcement We found two breaches of regulation. You can see the action we have asked the provider to take in the main body of the report.

Follow up: We will ask the provider to send us a plan of how they will improve and ensure regulations are met. These will be checked at our next inspection.

The inspection was announced. The provider was given 48 hours' notice because we wanted to make sure the registered manager and staff would be available to speak with us. The inspection was carried out by one adult social care inspector.

There was a registered manager in post at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. 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.

Shining Care Ltd registered with CQC on 10 November 2016. This was our first inspection of the service provided. Therefore, Shining Care Ltd had not previously received a rating from CQC.

As a result of this inspection we have rated the service as Good.

The registered manager and staff understood their role and responsibilities to keep people safe from harm. Risks were assessed and plans put in place to keep people safe. There was enough staff to safely provide care and support to people. Checks were carried out on staff before they started work to assess their suitability to support vulnerable people. Where people required assistance with taking medicines this was managed and people received the support identified in their care plans.

Staff received regular supervision and the training needed to meet people’s needs. The registered manager and staff understood the principles of the Mental Capacity Act (MCA) 2005 and, worked to ensure people's rights were respected.

People were cared for by staff who knew them well. Staff treated people with dignity and respect. Care was taken to ensure care staff were able to communicate with people using their preferred language. The manager and staff had a good understanding of equality, diversity and human rights.

The service was responsive and people received individualised care and support. People were encouraged to make their views known and the service responded by making changes. The registered manager said they welcomed comments and complaints and saw them as an opportunity to improve the care provided.

The vision, values and culture of the service were clearly communicated to and understood by staff. A quality assurance system was in place. This meant the quality of service people received was monitored on a regular basis and where shortfalls were identified they were acted upon.