Background to this inspection
Updated
18 March 2023
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 one inspector and one Expert by Experience. An Expert by Experience (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.
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
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 would be in the office to support the inspection.
Inspection site visit activity started on 7 February 2023 and ended on 8 February 2023. We visited the office location on both days to see the registered manager and office staff, review care records, policies and procedures. The EXE made telephone calls and spoke with 5 people on 13 February 2022.
What we did before inspection
We reviewed information we had received about the service since the last inspection. 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 received feedback from a health and social care professional which has been included in the planning of this inspection.
During the inspection-
We spoke with the registered manager about the improvements they had made since our last visit.
We spoke with 4 people, 1 relative, a live-in care worker, care coordinator, care manager and the registered manager who was also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We viewed 3 care plans, 3 staff files in relation to recruitment, induction and supervision, training data, policies and procedures and a variety of records relating to the management of the service.
We sent feedback questionnaires to 7 staff members and received 5 responses. We continued to seek clarification from the provider to validate evidence found. All information received was used as part of our inspection process.
Updated
18 March 2023
About the service
Cure Healthcare Services Limited is domiciliary care service that is registered to provide personal care and support to people in their own homes. It provides care to people with dementia, autistic people, people with a learning disability and people with a mental health condition living across Buckinghamshire and Slough. At the time of our inspection there were 7 people using the service.
People’s experience of using this service and what we found
People felt safe from abuse and relatives said they were safe from abuse. Comments included, I am so safe with her (care staff) and I miss her when she leaves” and “I have two people at a time and I am always looked after and safe.”
People were kept safe from avoidable harm because staff knew how to protect them from abuse. The registered manager made sure risk assessments relating to people’s health and welfare were completed and regularly reviewed. There was sufficient staff to support people and safe recruitment practices was employed. Medicine practices were safe because staff received appropriate training and their competency to administer medicines was assessed. There were appropriate infection control practices.
Care and support were planned and delivered in line with current evidence-based guidance, standards, best practice, legislation. Assessment of people’s needs were comprehensive and were developed with involvement of people and their relatives. People’s nutritional needs were met. Staff were appropriately inducted, trained and supported and worked collaboratively with external agencies to ensure people had good health outcomes.
People felt valued by staff who showed genuine interest in their well-being and quality of life. A person commented, “I like them (staff) very much and I like them coming to help me, they are very kind to me.” People were treated with dignity, respect, and kindness. People were supported to express their views and were involved in decisions relating to their care.
People received personalised care to ensure they had choice and control and to meet their needs and preferences. The service was responsive to people’s needs. People said they had no complaints about the service and knew what to do if they needed to. The provider had systems to receive, handle and investigate complaints.
Governance processes¿were effective and helped the service to ensure the welfare and safety were protected and provide good quality care and support. The service has a positive culture that is person-centred, open, and empowering. Staff understood their role and responsibilities, were motivated, and had confidence in the management team. The service worked collaboratively with health and social care professionals to make sure people had access to services of need.
People were supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.
Right Support:
People were not supported to have maximum choice and control of their lives. Staff had received appropriate training to support autistic people, people with dementia, people with a learning disability and people with a mental health condition. Care plans contained enough information to enable staff to support people and meet their individual needs.
Right Care:
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.
Right Culture:
People and those important to them, including advocates, were involved in planning their care. Staff felt respected, supported and valued. They said the service promoted equality and diversity in daily work and provided opportunities for development and career progression. They could raise any concerns without fear.
Rating at last inspection and update
The last rating for this service was requires improvement (published 18 August 2019) and there was a breach 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
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for on our website at www.cqc.org.uk.