Background to this inspection
Updated
15 May 2021
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 Care Act 2014.
Inspection team
The inspection was carried out by an inspector, assistant inspector and two Expert by Experiences (EXE). An EXE 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.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because due to COVID-19 restrictions we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 30 March 2021 and finished on 9 April 2021. We visited the office location on 30 March 2021.
What we did before the inspection
We reviewed information we had received about the service since registration. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We used all this information to plan our inspection.
During the inspection
We spoke with 23 people who used the service and 14 relatives about their experience of the care provided. We spoke with five members of the care staff, care coordinator, branch analyst, the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included eight people’s care records, medication administration records and the daily notes recorded by care staff. We looked at three staff files in relation to recruitment and staff supervision and a variety of records relating to the management of the service, including policies and procedures and training records.
After the inspection
We asked the registered manager to provide us with a variety of policies and procedures and additional information. All information was sent within the required timeframe. We used all this information to help form our judgements detailed within this report.
Updated
15 May 2021
About the service
Fosse Healthcare - Ashfield is a domiciliary home care service providing personal care to 183 people within 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.
People’s experience of using this service and what we found
The risk of people experiencing avoidable harm was reduced because the provider had processes in place to act on concerns raised and informed other agencies where required. The risks to people’s health and safety were assessed, monitored and reviewed to ensure people continued to receive safe care. There were enough staff in place to meet people’s care needs. The provider had experienced staff shortages due to the impact of COVID-19. Contingency plans meant the most vulnerable were protected from harm during this period.
People’s medicines were managed safely. Robust infection control and COVID-19 policies meant the risk of the spread of infection was reduced. The provider ensured staff learned from mistakes with increased training and supervision where needed.
People received care that protected them from discrimination. Staff were well trained and received supervision of their role and assessment of their competency. Some staff had not yet received an annual appraisal due to the impact of COVID-19. People were supported to maintain a healthy lifestyle and balanced diet. Staff worked in partnership with other health and social care professionals to provide timely and effective care.
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 felt staff were kind and caring and they were treated with respect and dignity. People’s choices about their care were respected and acted on.
People received care that was personalised to their needs, choices and preferences. Access to an electronic care planning monitoring app was increasing, giving people and relatives additional reassurance that appropriate care was being provided. The provider had systems in place to enable them to provide documentation in alternative formats; making information accessible for all. The provider responded to formal complaints in accordance with their complaints policy.
People raised concerns about the way office staff communicated with them. Some felt they were not always listened to and issues raised were not always acted on. Some felt unable to gain a positive response when contacting the office. Action had already been taken by the provider to address this.
Robust quality assurance processes were in place. These were monitored by the registered manager and made available to senior management to ensure that quality of care provision met the required standards. The registered manager was knowledgeable about the regulatory requirements of their role and they were supported by the nominated individual to carry out their role effectively.
For more details, please see the full report which is on the CQC website at
Rating at last inspection This service was registered with us on 1 May 2020 and this is the first inspection.
Why we inspected
The inspection was prompted in part due to concerns received about staffing. A decision was made for us to inspect and examine those risks.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the Safe section of this full report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.