29 May 2019
During a routine inspection
Key Care & Support Limited is a domiciliary care service, which provides support for both children and adults in the community, who require assistance with personal or nursing care. At the time of this inspection two adults were receiving personal care provided by Key Care & Support.
People’s experience of using this service and what we found
The provider had not ensured health care risks had been appropriately managed. Although staff understood where people required support to reduce the risk of avoidable harm, the care records did not contain explanations of the control measures to keep people safe. New staff had been recruited carefully and the consistency of staff teams helped to ensure people were safeguarded against abusive situations. Medicines were managed well and the staff team were trained in the prevention of cross infection.
People’s interests were documented within the care files and their likes and dislikes were recorded well. However, we recommend the provider obtains more detailed information about how people’s needs are to be best met before a package of care is arranged. The staff team were trained, but we recommend the provider makes improvements around end of life care and the formal supervision of staff.
People were not supported to have maximum choice and control of their lives, which was in their best interests. This was because care records we saw did not demonstrate the Mental Capacity Act was being followed or decisions were being made in people’s best interests. However, relatives told us staff supported people in the least restrictive way possible and the policies and systems in the service supported this practice.
Systems were in place for the management of complaints. People were treated with kindness by a caring staff team and their privacy and dignity was consistently respected. However, the provider had failed to ensure people’s care was properly planned and therefore person-centred care was not always being provided.
There was little oversight of the service and a robust system for assessing and monitoring the quality of service provided had not been established. Therefore, there were significant failings within the governance of the service, which resulted in the well-led domain being rated as Inadequate.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
This was a planned inspection based on the previous rating.
The last rating for this service was good (Published 6 December 2016). Since this rating was awarded the service has moved premises. We have used the previous rating to inform our planning and decisions about the rating at this inspection.
The overall rating for the service has changed from good to requires improvement. This is based on our findings at this inspection. We have found evidence that the provider needs to make improvements. Please see the sections of this full report. 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 Key Care & Support Limited on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to safe care and treatment, need for consent, person-centred care and good governance at this inspection.
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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.