Top Class Quality Services Ltd

Updated 1 November 2019

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

This inspection was carried out by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes.

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. The registered manager was also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. As they are the same person we will refer to them as the registered person throughout this report.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection. We also wanted to be sure there would be people at home to speak with us.

Inspection activity started on 20 September 2019 and ended on 30 September 2019. We visited the office location and completed a home visit on 20 September 2019. Between 20 and 30 September we contacted health and social care professionals identified by the registered manager and staff members not available on the day of the site visit.

What we did before the inspection

We reviewed the information the registered person sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We reviewed the notifications received from the provider, since the last inspection. The law requires providers to send us notifications about certain events that happen during the running of a service. We contacted local authority teams engaged with the service, including clinical commissioning groups, continuing health care groups, safeguarding and quality assurance teams. We used this information to plan our inspection.

During the inspection

We spoke with the a person who uses the service, a person's relative, the registered person, the care coordinator and a support worker.

We reviewed the service care records, including two people’s care plans and medicine administration records, risk assessments relating to skin care, falls management, and nutrition. We reviewed the daily progress notes of two people. We looked at eight staff recruitment and training files, together with the provider’s training and supervision schedules. We also examined other documents relating to the management of the service, including policies, procedures, quality assurance documents, audits and satisfaction surveys.

After the inspection

We spoke with four support workers and three health and social care professionals. We continued to seek clarification from the provider to validate evidence found during the site visit. This included further documentation that had been provided following discussions with the registered person and care coordinator.

Updated 1 November 2019

About the service

Top Class Quality Services Ltd is a domiciliary care agency based in Reading, providing personal care to people living in their own homes. At the time of inspection, the provider was supporting two people in their own homes with a 24-hour live-in service.

People’s experience of using this service and what we found

People were protected from avoidable harm by staff who had received appropriate training and knew how to recognise and report abuse. Staff provided the support people required to keep them safe and protect them from identified risks, such as malnutrition, falling, choking, developing pressure sores and infections. The registered person operated robust recruitment processes in accordance with legislation, to ensure there were enough suitable staff to meet people's needs safely. People received their prescribed medicines safely from staff who had completed the required training and had their competency to do so assessed regularly. Staff had the necessary skills to meet people's needs safely, in line with good practice.

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.

There was an open and positive culture within the service, which enabled encouraged good communication with people, their families and other stakeholders. The registered person and care coordinator ran the service well and supported staff to develop their skills. The registered person effectively engaged with people, staff and professionals to seek their views, which were used to drive service improvements. Quality assurance processes were in place to ensure the registered person had oversight of the service performance. The registered person and staff worked well with key organisations to ensure the safe and effective delivery of people’s care. Professionals consistently praised the service for compassionately supporting people with challenging needs, where other providers had failed. For example, one professional told us, “I would say the safety and quality of care is excellent, for obtaining equipment needed and keeping [person] safe in her own home and enabling family and friends to visit.”

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 4 June 2019) and there were three breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those Key Questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. 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 Top Class Quality Services Ltd on our website at www.cqc.org.uk.

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.