Vision Care Services

Updated 16 January 2024

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

The first day of inspection was carried out by 2 inspectors, the second day of inspection was carried out by 1 inspector. Between the onsite inspection dates an Expert by Experience conducted calls to people and relatives. 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 24 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 8 November 2023 and ended on 22 November 2023. We visited the location’s office on 8 and 13 November 2023.

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 other external stakeholders. 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 used all this information to plan our inspection. 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.

During the inspection

We reviewed a range of records. This included 5 people's care records and multiple medicine records. We reviewed 3 staff recruitment files and a variety of records relating to the management of the service.

We spoke with 5 relatives and 8 people who use the service about their experience of the care received, and we spoke with 9 staff members inclusive of the nominated individual and the registered manager.

The nominated individual is responsible for supervising the management of the service on behalf of the provider.

Updated 16 January 2024

About the service

Vision Care Services is a domiciliary care service which provides care and support for 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 start of the inspection the service was supporting 196 people with personal care. Due to changes implemented by Bradford Council by the end of the inspection the service was supporting 149 people.

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

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.

Right Support:

Medicines were not being safely managed. Risks to people were not always consistently or effectively managed. We found multiple risk assessments were not in place for people where needed. Staff had not received all the necessary training to enable them to provide safe and person-centred care appropriate to people’s specific medical conditions.

People were being safeguarded from the risk of abuse as staff were reporting concerns and these were being acted on by management.

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.

Right Care:

Care plans were detailed relating to people’s preferences for care call activities, however where people had specific health needs the care plans did not provide guidance to staff on how these conditions affected people or how they should support them safely.

People and relatives told us they were very happy with the care being provided by the service.

The service was working effectively with external professionals.

Right Culture:

The provider did not have safe and effective systems in place to monitor, review and improve the quality of care provided. The shortfalls found on inspection had not been identified by the provider during their internal audit processes.

We were not assured lessons were being learnt due to ineffective audit systems.

Staff were compliant with infection prevention and control measures and procedures, and the provider had sufficient supplies of personal protective equipment.

The provider was very proactive with gaining feedback from people, relatives and staff and engaged with them regularly to review their view of the care being received.

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 good (published 20 November 2018).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding.

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.

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 Vision Care Services on our website at www.cqc.org.uk

Enforcement

We have identified breaches in relation to medication management, staff training, managing risks and good governance at this inspection. 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.