Flexserve UK Limited

Updated 31 January 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. 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 inspection was carried out by 1 inspector and 1 Expert by Experience who contacted people and their relatives for feedback on the care people received. 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, flats and/or specialist housing.

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 48 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.

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. We reviewed the information we gathered as part of our monitoring activity that took place on 23 June 2022. 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.

During the inspection

We spoke with 3 people who used the service and 7 relatives/friends of people using the service about their experience of the care provided. We spoke with 6 members of staff including the registered manager and care workers.

We reviewed a range of records including 5 people's care records and medicines records for 3 people. We looked at 5 staff files in relation to recruitment, training and supervision. A variety of records relating to the management of the service, including policies and procedures, complaints and audits were also reviewed.

Updated 31 January 2023

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.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

About the service

Flexserve UK Limited is a domiciliary care agency providing personal care and support to people living in their own homes. The service supported mainly older people, people living with dementia and people who had physical disabilities. At the time of the inspection, 34 people were using the service. Not everyone received the regulated activity, 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

Right Support:

Some risks in relation to people's care and welfare were not thoroughly assessed which could have impacted on people’s safety. We discussed this with the registered manager who had started to make changes to improve people’s risk management plans.

We found minor shortcomings around medicines management which the registered manager rectified immediately following the inspection.

Where required, staff supported people to access specialist health and social care support in the community. Staff supported people to play an active role in maintaining their own health and wellbeing.

Staff supported people to make decisions following best practice in decision-making. 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:

People received care and support from a consistent and knowledgeable staff team. However, recruitment practices were not always safe because recruitment checks did not always meet requirements.

The service had enough appropriately skilled staff to meet people’s needs and keep them safe. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies. Staff had training on how to recognise and report abuse.

Staff promoted equality and diversity in their support for people. They understood people's cultural needs and provided culturally appropriate care.

People received kind and compassionate care. Staff understood and responded to people’s individual needs.

Right Culture:

The service evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. However, quality assurance systems were not always effective as they had not identified the issues we found.

People and those important to them were involved in planning their care. Staff valued and acted upon people’s views.

Staff turnover was low, which supported people to receive consistent care from staff who knew them well.

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 27 December 2018).

Why we inspected

This focused inspection was prompted by a review of the information we held about this service.

This report only covers our findings in relation to the key questions safe, effective and well-led. For the 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. 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 Flexserve UK Limited on our website at www.cqc.org.uk.

Enforcement and recommendations

We have identified breaches in relation to staff recruitment and the governance of the service at this inspection.

We made a recommendation about assessing people’s risks.

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.