Supreme Care Services Limited

Updated 24 January 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 Health and Social Care Act 2008.

Inspection team

This inspection was carried out by 4 inspectors, and 2 Experts by Experience. An Expert by Experience 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.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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. At the time of our inspection there was a registered manager in post.

Notice of inspection

The provider was given 15 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on the 9 November and finished on the 28 November. We visited the location's office.

What we did before the inspection

We reviewed information we had received about the service since the last 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.

During the inspection

We spoke with 5 care staff, the registered manager and the branch manager as well as the nominated individual. We reviewed a range of records. This included people's care and support records and people's medicine administration records. We looked at staff files in relation to recruitment and staff training records. We also reviewed a variety of records relating to the management of the service, including policies and procedures, staffing rotas, accident and incident records, safeguarding records and quality assurance reports. We also reviewed the action plan from the last inspection.

After the inspection

Our experts by experience made calls to 9 People and 2 relatives and we also called 8 care staff. We also continued to seek clarification from the provider to validate evidence found. We looked at policies and procedures.

Updated 24 January 2023

About the service

Supreme Care Services is a domiciliary care agency providing personal care and support to people in their own homes. Not everyone who used the service received personal care. At the time of the inspection 315 people were receiving personal care. The Care Quality Commission 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

Some people told us that their care was delivered on time, and they had no concerns with staff calls, however one person told us “the service was unreliable, as their care staff are late.” We reviewed the monitoring call systems, which showed late calls were recorded and actions taken for example the office called the person to inform them that their care staff were running late and offered another staff, which people declined as they wanted their regular staff. However, we found that people did not always get their visits at the agreed time.

People and their relatives told us they felt safe with the care staff who visited them. Staff were recruited safely. People were protected from the risks associated from the spread of infection. Medicines were managed safely. People had risk assessments to protect them from harm.

People's needs were assessed before they used the service. The service worked together with healthcare professionals to ensure people's needs could be met. People were supported with their nutritional and hydration needs. Staff were supported with training and supervision.

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.

Staff demonstrated they knew people well and understood the way people wanted to be cared for. Staff obtained people's consent before delivering care. Staff understood how to provide personalised care. Care records were in place and contained information about people's preferred method of communication.

We found that people’s crisis plans were not always personalised in some areas. We have recommended the provider review their crises plans.

We found that the provider’s monitoring systems did not always pick up some errors in people’s care files and review notes. We recommend the provider refers to current guidance in relation to their quality monitoring system.

The registered manager spoke positively of their plan for improving the service to ensure they gave people good quality care. Staff told us they felt supported by the management team.

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 Requires Improvement (published 27 August 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve. Although we found some improvements at this inspection, the provider remains in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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

You can see what action we have asked the provider to take at the end of this full report.

We will continue to monitor the service and will take further action if needed.

We have identified a breach in relation to staff deployment due to late calls at this inspection.

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

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 continue to monitor information we receive about the service, which will help inform when we next inspect.