Support Solutions (West Sussex)

Support Solutions (West Sussex) is a domiciliary care agency. At the time of our inspection the service was supporting 22 people. The service provides personal care to adults living in their own homes, some of whom were living with long term health conditions, as well as conditions associated with old age and frailty. CQC only inspects the service being received by people provided with 'personal care', which includes 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

Since our last inspection it was evident the provider and staff had made improvements which had raised the standard of care people received and improved the management of risks to people's health and safety. Improvements were still required to ensure quality assurance systems were effective in providing managerial oversight of all risks to people’s safety, people’s care, staff recruitment and medicines.

People at risk of falls were not always protected from avoidable harm because contributory risk factors had not been identified. Some staff had not undergone pre-employment checks in line with the providers policy to ensure they were safe and of suitable character to work with people.

People told us they felt safe and were cared for by staff who knew them well. People were administered medicines by staff who were assessed as competent in the task. There were enough staff to meet people’s needs and people told us staff arrived on time for their care calls. One person told us, “They [staff] are very strict on that. They are never late; I can’t fault them.” Another said, “They are really good at time keeping. Carers don’t leave until [person] is comfortable.”

People’s needs were assessed and regularly reviewed. People told us they felt involved in their care and were invited to provide feedback. Staff completed an induction and underwent training the provider considered essential to their role. People were cared for by staff who received regular supervision and felt supported by the provider.

People were supported to eat and drink enough and access healthcare services when required. People received personalised care that met their needs and preferences. Staff worked with external agencies to provide effective 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.

People spoke warmly and positively about staff and said staff treated them with respect and dignity. One person said, “Carers listen, look at me and treat me with respect. They are very polite and caring." Another told us, “Carers call me by my Christian name and always give me a hug.”

People and staff were complimentary about the provider, their colleagues and the culture of the service. One person told us, “I would always ring the manager. They are very easy to talk to.” A staff member said, “This is a good company to work for.” Another told us, “The manager is very approachable.”

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 21 January 2022) and there were five breaches of regulation. The provider was served a Warning Notice and completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found some improvements had been made and the provider was no longer in breach of four regulations. However, improvements were still required in relation to the overall governance of the service and there was a continued breach of regulation 17.

Why we inspected

The inspection was prompted in part due to concerns received about the culture of the service, medicines and the providers response to concerns and safeguarding. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from these concerns.

We also needed to follow up on action we told the provider to take at the last inspection and check whether the Warning Notice we previously served in relation to regulation 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. 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.

The overall rating for the service has not changed following this comprehensive inspection and remains Requires Improvement.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Support Solutions (West Sussex) on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified a continued breach in relation to the governance of the service. 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.

Support Solutions (West Sussex) is a domiciliary care agency. At the time of our inspection the service was supporting 15 people. The service provides personal care to adults living in their own homes, some of whom were living with conditions such as dementia, diabetes, respiratory conditions and general frailty. CQC only inspects the service being received by people provided with 'personal care', which includes 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

Information in people’s care records and staff knowledge was not enough to ensure safe care. Processes were not in place to ensure support plans contain detailed and person-centred information to accurately reflect the needs of people. There was a failure to assess and mitigate known risks to people such as those associated with reduced mobility, falls, cognitive impairments and diabetes. Processes failed to ensure medicines were administered in line with people's assessed needs.

People were not protected from the risk of contracting COVID-19. Processes were not in place to identify or mitigate risks to people who were considered to have increased vulnerability if they contracted COVID-19. Processes were not in place for staff to undertake COVID-19 testing in line with government guidance.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

People and their relatives told us the service they received was safe. The provider carried out checks before staff commenced employment to ensure their suitability to work with people. Staff received comprehensive training to ensure they had the required knowledge and skills to undertake their role.

People were very positive about the service and the provider. People told us they were cared for by staff who were kind and compassionate. Feedback received included “They are nice, friendly and efficient”. And “I would recommend them to anyone for the attention they give to me”. People told us the service they received was reliable and flexible to suit their needs.

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 registered with us on 11 September 2020 and this is the first inspection.

Why we inspected

This is the first inspection for this newly registered service.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to providing safe care and treatment, medicines, protecting people from harm, consent to care and treatment, person-centred care and support and the management of the service at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.