Perspecktive Limited was rated Good overall at its first CQC inspection, demonstrating a strong person-centred culture with safe medicines management, consistent staffing, and high relative satisfaction. The sole Requires Improvement rating in Effective reflected incomplete Mental Capacity Act capacity assessments and missing Deprivation of Liberty Safeguards authorisations for people under 24-hour supervision, alongside a failure to notify CQC of a serious injury incident.
Concerns (4)
moderateConsent / capacity: “Assessments did not always include people's ability to make decisions or who made decisions on people's behalf, if they were unable to do this themselves.”
moderateConsent / capacity: “Not all the people who required 24 hour supervision had applications submitted. Where people lack capacity to make decisions and are continually supervised, an authorisation to restrict their freedom should be applied for.”
moderateGovernance: “They were not aware of all the notifications they were required to send to us when reportable incidents had occurred. We found one incident where a person had a serious injury that we had not been told about.”
minorRecord keeping: “The managers said they would make sure copies of assessments were obtained. They said they would also include this in their initial assessment procedure to ensure copies were requested in future.”
Strengths
· People were at the heart of the service with a strong person-centred philosophy shared across all staff.
· Medicines were managed safely with regular audits of medication administration records and competency checks for staff.
· Consistent staffing with no agency staff used; managers covered absences personally to ensure continuity.
· Thorough staff recruitment process including DBS checks, references, and values-based scenario assessments.
· Robust risk assessments that were detailed, up to date and reviewed regularly, enabling positive risk-taking.
Quality-Statement breakdown (20)
safe: Safeguarding and protection from abuseGood
safe: Risk assessment and managementGood
safe: Staffing levels and consistencyGood
safe: Recruitment practicesGood
safe: Medicines managementGood
effective: Staff training and skillsGood
effective: Supervision and appraisalGood
effective: Mental Capacity Act compliance and DoLSRequires improvement
effective: Nutrition and hydrationGood
effective: Health monitoring and healthcare accessGood
caring: Kindness, dignity and respectGood
caring: Involvement in care decisionsGood
caring: Promotion of independenceGood
responsive: Person-centred care planningGood
responsive: Complaints handlingGood
responsive: Response to changing needsGood
well-led: Leadership and management cultureGood
well-led: Quality assurance and governanceGood
well-led: Regulatory notifications to CQCRequires improvement
Perspecktive Limited is a Good-rated domiciliary care agency in Coventry providing person-centred support to five people with learning disabilities and/or autism, with all five key questions rated Good. The service demonstrated notable improvement in mental capacity assessments since the previous inspection, with consistently strong leadership, staff training, and partnership working with health and social care professionals.
Strengths
· People and relatives spoke positively about staff who knew them well and provided person-centred support promoting choice, control and independence.
· Robust recruitment, DBS checks, and comprehensive mandatory training ensured a competent and consistent workforce.
· Mental capacity assessments and best interest processes were improved and sustained since the previous inspection.
· Risk assessments were thorough, regularly reviewed, and shared with staff; emergency procedures were clearly documented.
· Medication administration records were correctly completed with regular senior staff audits.
Quality-Statement breakdown (22)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Assessing people's needs and choices; ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving care; working in partnership with othersGood