JSS Homecare Ltd is a domiciliary care agency providing personal care and support to people living 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 6 people were receiving personal care from the service. We carried out an assessment of the service which started on 17 January 2024 and was completed on 1st February 2024. This was to check if the service made improvements following the recommendations we made at the last inspection (published 12 January 2023) in relation to risk management, training and the associated quality assurance systems. The provider demonstrated they had been keen to improve and had an action plan in place to evidence this. At this assessment we found improvements had been made and the provider met the recommendations. As part of the assessment, we reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan and form part of our assessment. We spoke with 5 staff members, this included the registered manager, the deputy manager, the care coordinator and 2 care staff. We sought feedback from 2 people who use the service and 2 relatives of people who use the service. We reviewed a range of records. This included 3 people’s care documentation. We looked at 3 staff files in relation to recruitment and a variety of records relating to the management of the service, including quality monitoring and staff training.
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JSS Homecare Ltd, a small domiciliary care agency on its first inspection, was rated Requires Improvement overall due to gaps in risk assessments, incomplete staff training (including absence of Care Certificate completion and condition-specific training), undocumented competency assessments, and ineffective quality assurance systems. Caring and responsive practice were rated Good, with people and relatives speaking positively about staff and the service, and the provider demonstrating openness to acting on inspection feedback promptly.
Concerns (8)
moderateCare planning: “some of the information within these was limited and lacked person-centred detail and guidance for staff.”
moderateStaff training: “Staff that were new to care had not completed the Care Certificate, or training of a similar level.”
moderateStaff competency: “The provider told us staff competencies had been assessed during the induction...However, this had not been documented.”
moderateStaff training: “Staff did not receive training specific to people's individual needs. For example, dementia and catheter care.”
moderateGovernance: “Quality assurance systems were not fully effective and did not highlight all the concerns we found during this inspection.”
moderateRecord keeping: “General environmental risks in people's homes were not completed in relation to risks such as food hygiene and fire safety.”
minorEnd-of-life care: “Care plans did not consider people's end of life wishes...Staff had not received end of life training.”
minorRecord keeping: “One staff member had not provided a full employment history on their application form.”
Strengths
· People were supported by enough staff and the nominated individual ensured new packages of care were only taken on if sufficient staffing existed.
· Safe recruitment checks including DBS checks and references were carried out before employment was offered.
· Staff received safeguarding training and knew how to protect people from abuse, harm and neglect.
· People received safe support with medicines and staff competency assessments for medication were completed.
· People, relatives and staff spoke positively about the service; one person stated 'I have perfect confidence in their hands.'
Quality-Statement breakdown (21)
safe: Assessing risk, safety monitoring and management; Preventing and controlling infectionRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Learning lessons when things go wrongGood
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
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: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversity; privacy, dignity and independenceGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportRequires improvement
well-led: Managers and staff being clear about their roles, quality performance, risks and regulatory requirements; Continuous learningRequires improvement
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: Engaging and involving people using the service, the public and staffGood