Competent Healthcare Ltd

Competent Healthcare Ltd is a home care service providing personal care to people in their own home. The service provides support to older adults who may be living with dementia, a physical disability, sensory impairment or mental health diagnosis. At the time of our inspection there were 15 people using the service. The service supported people living in the Southampton area.

Not everyone who used the service received personal care. CQC 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

The provider had made significant improvements around their governance processes and systems to monitor the quality of care. There was a clear management structure in place to help ensure key aspects of the service were run safely and effectively. The provider had demonstrated a commitment to work with stakeholders to make changes which had led to sustained improvements in the quality of care. There was a positive atmosphere at the service, with people, relatives and staff telling us leaders were approachable and professional.

The provider had made improvements around staffing since our last inspection. There were now systems in place to ensure there were sufficient numbers of staff in place, who had appropriate training and support in their role. Risks related to the delivery of care were assessed and reduced. There were appropriate policies and procedures in place to support people to safely manage their medicines. The provider had systems in place to safeguard people from suffering abuse or coming to avoidable harm.

There were appropriate processes in place to gain people’s consent to care. 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. The provider had effective systems to assess people’s needs and provided support around people’s healthcare.

People told us that staff were caring and took time to get to know them as individuals. Staff were patient and did not rush people when providing care. People told us they were involved in making decisions about their care and that they were treated with dignity and respect.

The provider was completing work to ensure people’s care plans were person centred and reflective of the support people required. Care was organised around the needs of people and the provider was flexible and responsive when changes were required. There were systems in place to monitor care pro-actively with the use of electronic care planning systems. The provider listened to people’s feedback and acted appropriately to investigate complaints or concerns.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 30 November 2021) and there were 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 enough improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

At the last inspection we found the provider was in breach of regulation. This inspection was carried out to review actions the provider told us they would take to comply with the regulation and improve the service. As a result, we undertook a comprehensive inspection to review the overall quality and safety of the service.

The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

Follow up

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

Competent Healthcare Ltd is a home care agency supporting people with personal care in their own homes. Not everyone who used the service received personal care. CQC 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. At the time of the inspection the service was supporting six people with personal care.

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

People told us they received inconsistent care. They said that communication with the office could be improved as they were not always informed about changes to their care.

People and staff told us the registered manager was approachable and responsive. However, they also said that former office staff did not always embody these qualities, which contributed to a negative culture at the service. The registered manager acknowledged these issues and had taken steps to build a more positive ethos within the senior staff.

The provider did not have an effective system in place to monitor staff’s ongoing training needs. This resulted in staff not always receiving the appropriate training and support in their role.

Medicines administration records [MAR] were not always in place, which meant staff could not accurately record medicines administered. The provider did not have an established system to collect and audit completed records or distribute records for future use. This meant the provider had limited ability to pick up on errors or concerns around people’s medicines.

There was not an effective governance system in place to oversee the quality and safety of the service. The systems around auditing of care records and care plans were not completed consistently and did not drive improvement in quality or safety.

The provider sought people’s feedback through quality assurance questionnaires, but feedback was not always acted upon or used as an opportunity to make improvements.

The registered manager had recognised where improvements were needed and had developed an action plan which detailed how changes would be made. At the time of inspection, many actions were ongoing and not all improvements had been imbedded or sustained.

There were enough staff in place to meet people’s needs. The service had recently reduced the number of people they provided care too due to acute staffing shortages. The registered manager told us they were consolidating the size of the service until they were able to recruit more staff.

The provider carried out appropriate recruitment checks to help ensure suitable staff were employed.

The provider had investigated incidents and concerns to help prevent people from suffering abuse or coming to avoidable harm.

Risks from the spread of infections such as COVID-19 had been considered. Staff took measures to prevent the spread of infections for example by wearing personal protective equipment.

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 17 August 2019).

Why we inspected

We received concerns in relation to leadership and governance, staffing levels and staff training. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them.

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

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

Follow up

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Competent Homecare is a domiciliary care service which provides personal care and support to people living in their own homes in the Basingstoke and surrounding area. At the time of the inspection the service was supporting 34 people.

For more details, please see the full report which is on the Care Quality Commission website at www.cqc.org.uk.

People’s experience of using this service:

• People received high quality care that was safe, effective, caring, responsive and well led.

• People and their relatives provided positive feedback about all aspects of the care they received.

• One person told us, “I couldn’t have better care, they always find time for a chat and will go out of their way to help me.”

• People experienced safe care, which protected them from avoidable harm and abuse. Staff had received relevant training and understood their role and responsibility in relation to safeguarding and keeping people safe.

• Staff ensured the human rights of people who lacked a voice, were upheld and respected.

• There were enough staff deployed to meet people’s needs. The nominated individual and registered manager covered any unforeseen staff absence.

• Staff felt they were valued and respected by the management team, who actively sought their involvement to improve and develop the service.

• Staff completed an effective induction programme, then were enabled by the provider to develop and maintain the required skills to meet people’s needs effectively.

• The provider completed regular competency checks to ensure staff delivered care in accordance with their training.

• We saw people were treated with kindness and compassion by staff who supported them to express their views and be actively involved in making decisions about their care.

• People received care from a regular staff team, with whom they had built trusting relationships.

• Staff supported people to be actively involved in making decisions about their care.

• People were impressed by the provider’s willingness to listen and respond to their concerns, which had instilled trust and confidence in the service.

• The nominated individual and registered manager led by example, set high standards and inspired staff to meet them.

• People’s care plans were comprehensive, providing staff with the required information about their needs and how to meet them.

• Staff worked effectively with local organisations to improve care practice and outcomes.

Rating at last inspection:

• This was the first inspection of Competent Homecare since they were first registered to provide personal care in February 2018.

Why we inspected:

• This was a planned comprehensive inspection, in line with our inspection programme.

Follow up:

• We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care, until we return to visit as per our inspection programme. If concerning information is received, we may inspect sooner.