Independent Care and Support Limited

Updated 24 May 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 an inspector and an Expert by Experience. 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 registered manager would be in the office to support the inspection.

Inspection activity started on 19 May 2023 and ended on 25 April 2023. We visited the location’s office on 19 May 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. 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

Contact was made with 7 people who used the service and 4 relatives about people’s experience of the care provided.

We also spoke with 5 members of staff including the registered manager, senior supervisor, administrator and two care workers.

We reviewed a range of records. This included 5 people’s care records, and 2 people’s medication records. We looked at 3 staff files in relation to recruitment and supervision, and the staff training matrix. A variety of records relating to the management of the service were viewed, including quality checks and audits.

Updated 24 May 2023

About the service

Independent Care and Support is a domiciliary care agency providing personal care and support to people in their own homes. The service is registered to provide care for older people, people with dementia, a physical disability and younger adults. At the time of the inspection the service was providing personal care to 76 adults.

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

Quality assurance and monitoring systems were not always effective in identifying shortfalls and improving the service for the people who used it. When complaints had been raised it could not be ensured the provider had taken sufficient action to minimise the chance of the same thing from happening again. The recruitment of staff had not included establishing satisfactory character references before staff worked without supervision. This included obtaining checks from staff who had previously worked in the social care.

Feedback from people was not effectively reviewed and used to make improvements to the service. Quality checks on staff were limited and did not include direct observation of staff administering medicines so their competency could be continuously assessed. The provider had obtained a number of tools to aid their quality assurance systems and planned to put them into practice.

There was inconsistency in the detail of staff guidance to support people with their care. There was not sufficient information about the signs and symptoms of infection for people who used a catheter. For people who were anxious, staff were advised to talk to them but there was no indication of what topics people liked to talk about.

Staff undertook regular training in essential areas but it did not include regular practical competency based moving and handling or medicines training. We have made a recommendation about moving and handling, medicines and catheter care training.

Staff supported people to access health care services in a timely manner. There were mixed views about how effective staff were in encouraging people to eat.

The majority of people and relatives said they would recommend the service to others. There were mixed views about the quality of communication with the management team.

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.

People told us they received kind and caring support from staff. A person told us, “Staff are very friendly and caring. We have conversations and we talk all the time. I get on very well with them.” A relative said, “I’ve actually been there when staff have been there and seen the way they act and speak to my mum; they are very kind and caring in that respect. My mum is very relaxed around them.”

There were enough staff to meet people’s needs and keep them safe. Staff understood how to protect people from poor care and abuse.

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 23 January 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. This included concerns about the overall management of the service. A decision was made for us to inspect and examine those risks.

Enforcement and Recommendations

We have identified breaches in relation to the recruitment of staff, management of complaints and governance of the service.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspection.