Flow Care Services Limited

Updated 3 July 2021

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

Our inspection was completed by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes.

The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

This inspection was announced. We gave the service two days’ notice of the inspection. This was because the service is small and the registered manager is often out working with people. We wanted to make sure someone would be available to meet with us.

The inspection site visit took place on 25 May 2021.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. This included details about incidents the provider must notify us about, such as allegations of abuse. We checked for feedback we received from members of the public, the local authority and clinical commissioning groups (CCGs). We did not request the provider to complete a provider information return. This is information providers are required to send us with key information about their service, what they do well and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

We spoke with the registered manager who was also a director and a second director. We reviewed a range of records. This included care records and risk assessments for two people and records relating to staff recruitment, training and support. A variety of records relating to the management of the service were also reviewed. After the inspection we spoke with two relatives of a person using the service and one support worker. We were unable to speak with any people using the service as they were unavailable or unable to speak on the phone.

Updated 3 July 2021

About the service

Flow Care Services Limited provides personal care for people who live in their own homes. At the time of the inspection there were four people receiving 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. The service provided staff to work in hospitals and care homes but we did not inspect these part of the business as it is outside our regulatory remit.

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

The provider had improved their recruitment practices since our last inspection, although they had not obtained a full employment history for each applicant as part of checking their suitability in line with the regulations. The registered manager told us this was an oversight and they would improve going forwards.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. This was because the provider did not always follow the Mental Capacity Act (MCA).

The registered manager did not always have sufficient oversight of the service through their system of checks and audits. These systems were not robust enough because they had not identified and resolved the concerns we found, such as those relating to recruitment and the MCA.

Staff understood and managed risks to people as the provider had assessed risks and put clear guidance in place for staff. There were enough staff to support people safely. Staff followed suitable infection control practices, including the safe use of personal protective equipment (PPE) to reduce the risk of COVID19 transmission, and received training on this. Although we did not find any evidence people had been harmed, records relating to medicines were not always in line with best practice.

Staff received a suitable induction with ongoing training and support on how to meet people’s needs. People were supported to maintain their health and staff understood people’s healthcare needs. People received food and drink of their choice.

People and their relatives liked the staff who supported them and developed good relationships with them. People received consistency of care from staff who knew them well. Some people were matched with staff from the same cultural, religious and linguistic background when requested. Staff treated people with dignity and respect. People were involved in their care and their care plan were based on their individual needs and preferences. The provider had systems to listen to and responded to any concerns or complaints.

A registered manager was in post who understood most of their role and responsibilities, although their knowledge of recruitment and the MCA required some improvement. Staff understood their role and responsibilities. Staff felt well supported by the management team. People, visitors and staff told us the service was well-led and the provider engaged well with them.

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

Rating at last inspection

This service was last inspected on 10 January 2020 and was not rated.

Why we inspected

This inspection was prompted because the service was unrated at our last inspection with one breach so we needed to check the service had improved and gather evidence to rate the service. We found the service had made some improvements in relation to recruitment although further improvements were required and we found new concerns relating to the MCA and oversight of the service. Please see the safe, effective and well-led sections of this full report.

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.