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 service was supporting three in their own homes. Care packages ranged from one hour a day to a 24 hour live in service.
People's experience and our findings:
Staff were not always trained or regularly assessed as competent to administer medicines in line with the provider’s policy, clinical guidance and best practice.
Where people were prescribed ‘as required’ (PRN) medication, the service did not always have protocols or guidance in place to ensure that staff knew when to administer PRN medicine.
Audits had not always been undertaken. Those that had, did not always identify gaps or highlight trends, themes or lessons learnt.
Care records did not always clearly reflect people’s care needs or how staff were supporting people with these needs.
Records of best interest discussions had not always been kept in relation to care and treatment of people.
Safe recruitment practices were not always followed to make sure, as far as possible, that people were protected from staff being employed who were not suitable.
People and their relatives told us they felt safe with the staff who supported them.
People and their relatives said staff were caring and respected their privacy and dignity.
People felt the service they received helped to maintain their independence where possible.
People knew how to complain and knew the process to follow if they had concerns.
Staff felt the management was supportive and approachable. Staff were happy in their role which had a positive effect on people's wellbeing.
Rating at last inspection:
The service was inspected on 6 March 2019 (report published 17 April 2019). We found the provider was in breach of Regulations 12 (Safe care and treatment), 17 (Good governance) and 19 (Fit and proper persons employed) of the Health and Social Care Act, (Regulated Activity) Regulations 2014. The service was rated as Requires Improvement.
Why we inspected:
This was a planned comprehensive inspection.
Enforcement:
At this inspection we found the provider continued to be in breach of Regulations 12 (Safe care and treatment), 17 (Good governance) and 19 (Fit and proper persons employed) of the Health and Social Care Act, (Regulated Activity) Regulations 2014. The service remains Requires Improvement.
Full information about CQC’s regulatory response can be found in the full report which can be found on our website at www.cqc.org.uk.
Follow up:
We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.