30 November 2022
During an inspection looking at part of the service
Signet Healthcare Limited is a domiciliary care agency providing personal care and support to people living their own homes. At the time of our inspection there were 53 people using the service.
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
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.
During the inspection we found risk assessments were not always robust enough and medicines were not always managed safely. Safe recruitment practices were not always followed.
The provider had procedures for managing incidents, accidents, safeguarding alerts and complaints, and quality monitoring processes in place, to help monitor and improve service delivery. However, these were not always effective, as they had not identified the areas where improvements were required that we found during the inspection.
People were not always supported to have maximum choice and control of their lives and the provider could not demonstrate people were always supported in their best interests. While the provider had policies and systems, these were not always robustly implemented.
We have made a recommendation for the provider to consider current guidance around recording in a person centred way.
Notwithstanding the above, people were satisfied with the care provided and felt safe. Staff received appropriate training to meet people’s care needs. People were supported by the same staff which provided consistency.
People using the service, their relatives and staff told us the management team were approachable and had responded to complaints.
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 good (published 16 May 2018).
Why we inspected
This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the key questions of safe, effective, responsive and well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive 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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Signet Healthcare Limited on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to safe care and treatment, consent to care, good governance and staffing 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.