Sentricare Birmingham

Updated 12 April 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

Two inspectors made a visit to the provider’s office location and two inspectors made phone calls to people and relatives using the service and to staff to gain their feedback.

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

This inspection was announced. We gave the provider 48 hours’ notice before attending the office location to ensure they were available to support us with the inspection.

What we did before the 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. We also contacted commissioners of care services for their feedback. We used all this information to plan our inspection.

During the inspection

We spoke with 5 people who used the service and 7 relatives. We also spoke with 12 care staff, the care co-ordinator and the registered manager who is the provider. We also used technology such as electronic file sharing to enable us to review documentation sent to us by the provider, following the site visits.

Updated 12 April 2024

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.

About the service

Sentricare Birmingham is a domiciliary care service providing personal care to people living in their own homes. At the time of our inspection the provider told us 76 people were using the service. The service was providing support to children, older and younger adults, people living with; dementia; learning disabilities; autism; mental health conditions; physical disabilities and sensory impairments.

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 provider could not demonstrate how the service met the principles of right support, right care, right culture. This meant we could not be assured of the choices and involvement of people who used the service in their care and support. There were several people being supported by the provider who had multiple needs including those with a learning disability and autism.

Right Support

We continued to be told people were not always supported to have maximum choice and control of their lives and they were not always involved in care reviews. Some people told us concerns they had raised these had not been addressed. Staff did not always support people in the least restrictive way possible and in their best interests.

We found guidance within some people’s care plans for staff members to follow when supporting autistic people or people with a learning disability who may express distress or frustration, had improved. Care plans and risk assessments in how to respond to such expressions did provide staff with information on how to respond, how to de-escalate for some people but not others.

Staff training and record keeping needed to be improved in relation to the Mental Capacity Act 2005 (MCA).

Right Care

People's care, treatment and support plans continued to not always reflect their range of needs or promote their wellbeing and enjoyment of life.

People who were known to express anxiety did not have proactive behaviour strategies documented in their care records. This meant they lacked detail on the specific actions staff should take to ensure practices were least restrictive to the person and reflective of a person's best interests.

Right Culture

Care was not always person centred and people were not empowered to influence their care and support.

Governance systems remained inadequate and not ensure people were kept safe and received high quality care and support in line with their personal needs.

At the last inspection the provider's oversight of the service had not identified some of the shortfalls we found during the inspection process as part of their audits and checks. At this inspection this continued.

Systems in place for managing complaints, safeguarding concerns, accidents, and incidents were not robust or effective. Not enough staff members were deployed by the provider to support people. The main complaint raised by people and their relatives continued to be the length and inconsistency of their care calls. Staff who attended people's homes remained inconsistent at times and for some staff their ability to communicate with people and their relatives was restricted due to language barriers.

People were supported by staff to take their medicines, however, guidance in place continued to not always be clear for staff to follow.

Staff did receive an induction when they started work but some people continued to tell us they felt staff members did not have appropriate skills and knowledge to support them how they wished.

Care plans and risk assessments continued to lack robust and clear guidance, with incorrect or conflicting information. Risk assessments continued to fail to direct staff on recognising symptoms of known health conditions.

People continued to tell us their care and support was not always planned in partnership with them, and persons close to them.

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 inadequate (published 22 March 2023).

At this inspection we found the provider remained in breach of multiple regulations and they had either not implemented or maintained the improvements they said they had made.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. The overall rating for the service has remained Inadequate. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see safe, effective, caring, responsive and well-led sections of this full report.

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

Enforcement

We have identified continued breaches in relation to; Regulation 9 - Person centred care, Regulation 10 – Dignity and respect, Regulation 11 - Need for consent, Regulation 12 – Safe care and treatment, Regulation 13 – Safeguarding service users from abuse and improper treatment, Regulation 16 – Receiving and acting on complaints, Regulation 17 – Good governance, Regulation 18 – Staffing and Regulation 19 – Fit and proper persons employed, Regulation 20 – Duty of candour at this inspection.

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

Follow up

The overall rating for this service remains ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.