13 December 2022
During a routine inspection
Quantum Domiciliary Care Limited is a domiciliary care agency providing personal care to people living in their own homes. The service provides support to people living with dementia, older and younger adults, people with learning disabilities and autism and people with physical disabilities. At the time of our inspection there were 17 people using the service.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
People’s experience of using this service and what we found
Right Support
Recording of some aspects of care was not always clear and made monitoring of risks more difficult. Guidance for staff on how to apply creams was not clear for some people. An ‘as needed’ medicine for 1 person did not have any guidance for staff on why and when to use it. People were supported by safe numbers of staff and were mainly supported by the same staff group. People received support tailored to their individual needs. Relatives told us they were happy with the support their loved ones received.
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. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. Staff knew people well and knew how they wanted to receive care. They understood what people could do for themselves and what they needed support with.
Right Culture
Some people’s care plans did not always include enough guidance for staff on how to support them with their care needs. Some care plans had not been updated with new guidance from other health professionals. Systems were in place to help staff monitor the quality of care plans, but they had not helped to identify the concerns we found. However, people were supported by the same staff who knew their care needs well and were aware of the updated guidance. The registered manager had not kept updated with national guidance. This meant staff had not received training to support people with learning disabilities and autism. This is now a legal requirement of the Health and Care Act 2022. We found no evidence that people had been harmed or were receiving inappropriate care as a result of this. People and their loved ones were involved in the planning and review of their care. Relatives told us they could get in touch easily with the management team and found them to be supportive. Staff told us they felt there was an open culture of learning in the team and the management were supportive. They spoke positively about the staff team and the managers.
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.
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 16 November 2019).
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 the provider remained in breach of regulations.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement
We have identified breaches in relation to the quality assurance and governance systems in place at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.