Date of inspection: 18 July to 20 August 2025. Supportive Care Services Ltd is a care at home service providing support to people living in their own homes. 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 supports older people, younger adults, people living with a mental health diagnosis, physical disabilities and people living with a learning disability and/or autism. At the time of our inspection the service was providing support to 12 people of which 7 were receiving person care. We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted. The inspection was prompted by information shared with us and a previous aged rating. We have assessed the service against all the quality statements in the key questions of safe, effective, caring, responsive and well-led. The provider was developing a learning culture to make improvements when things had gone wrong. However, this was not always effective. Following the last inspection, conditions were imposed on the provider’s registration to support improvements in service quality and monitoring. Despite this, the provider was unable to clearly demonstrate how these improvements had been achieved during this inspection. Some risks had not been identified and information put in place to support staff knowledge of specific medical and health conditions. There was conflicting information contained within the care plans that did not reflect information provided by the person at their initial assessment. It was not always clear from the care plans when they or the supporting risk assessments had been reviewed and updated. The provider oversight of the accuracy of care plans and risk assessments had not always been effective and had not identified the issues we found at this inspection. The provider’s oversight of staff training was not always effective. Training was not consistently completed in a timely manner, and its impact on staff competence and confidence was not routinely assessed. Gaps were found in both mandatory training and condition-specific training. The provider’s governance processes had not been effective in identifying where improvements were needed and how these improvements would be implemented and embedded into service delivery. The issues identified at the last inspection continued to be found during this inspection. Staff received supervision and told us they felt supported to maintain quality care. However, the supervision sessions with staff had not identified staff were completing tasks, such as medication administration, without the registered manager’s knowledge. The registered manager told us staff did not administer medicines or support people with applying topical creams. The provider oversight into how staff were supporting people had not identified staff were supporting people with medication administration and applying creams to people’s skins. Care was not based on latest evidence and good practice. Where people may have required support with their nutritional and hydration needs, care plans were not clear about the support people needed. People’s care was reviewed but information did not always reflect the support needs of people to ensure this remained effective. Information provided to people living with a learning disability could be made clearer and presented in a more suitable format, such as easy read. Most of the staff had completed safeguarding training. There were enough staff available to support people. There were no concerns identified with infection control practices. Staff understood the importance of supporting people’s independence and gaining people’s consent and involved people in decisions about their care. Staff protected people’s privacy and dignity and treated them as individuals supporting their individual preferences. The provider told us they had processes in place to investigate incidents, accidents, complaints and safeguarding concerns. We were unable to assess the effectiveness of the process because the provider told us there had been no complaints, incidents, accidents or safeguarding's since their last inspection. Staff told us they felt supported to give feedback and were treated well, free from bullying or harassment. Staff told us they understood their roles and responsibilities. The provider was previously in breach of the legal regulations in relation to assessing risks to the health and safety of people, processes to monitor and improve the quality of the service, the recruitment of their staff and providing their staff with the appropriate training. Enough improvements were not found at this assessment, and the provider continued to be in breach of these regulations and remains in special measures. The purpose of special measures is to ensure that services providing inadequate care make significant improvements. Special measures provide a framework within which we use our enforcement powers in response to inadequate care and provide a time-frame within which providers must improve the quality of the care they provide. In instances where CQC have decided to take civil or criminal enforcement action against a provider, we will publish this information on our website after any representations and/ or appeals have been concluded
npm run etl:reports -- --location 1-11488270256.Supportive Care Services Ltd, a Birmingham domiciliary care agency supporting 7 people, was rated Inadequate at its first CQC inspection in January 2023, with four regulatory breaches covering safe care, governance, staffing, and fit and proper persons employed. Widespread failures in risk assessment, medicines management, staff training, incident recording, and absence of any audit system placed people at risk of avoidable harm, resulting in the service being placed in special measures.