Date of assessment: 28 April to 12 June 2025. This assessment was prompted by information of concern received in relation to staffing, visit timing, and management. JC Healthcare Ltd is a homecare agency that provides personal care to people in their own homes. At the time of our assessment, 179 people were supported by the service, not all of those people were receiving the registered regulated activity of personal care. The service specialises in supporting people under and over 65 years old, living with dementia, physical disabilities and/ or learning disabilities. An assessment has been undertaken of a service that is used by autistic people or people with a learning disability but is not registered as a specialist service. We have 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. At our last assessment, we rated the service outstanding. At this assessment, the rating has changed to requires improvement. We identified 4 breaches of regulation in relation to person-centred care, safe care and treatment, consent and governance. The provider did not always ensure care records reflected people’s preferences and guidance for staff was not always clear. The provider did not always ensure risks were mitigated as reasonably practicable. The provider did not always ensure they were working in accordance with the requirements of the Mental Capacity Act 2005. The provider’s systems and processes did not identify the shortfalls we found at this assessment. We have asked the provider for an action plan in response to the concerns found at this assessment. People and their relatives were positive about the service and the care they received. We saw care and support that was tailored to their needs despite care records not always being complete and clear. People were supported to have choice and control and to maintain their independence. The management team were experienced and understood the needs of people using the service.
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J&C Healthcare Ltd achieved an Outstanding overall rating on its first CQC inspection, with Outstanding ratings for Caring and Well-led, driven by an exceptional person-centred culture in which staff and management consistently went above and beyond to enhance people's quality of life. No regulatory breaches or failure themes were identified, and robust governance, electronic care management, and strong partnership working underpinned consistently positive outcomes for all 126 people receiving personal care.
Strengths
· Staff consistently went above and beyond, with numerous examples of exceptional person-centred acts such as attending funerals, supporting people to attend family events, and bringing favourite foods.
· Robust and individualised risk assessments and care records reviewed regularly, with changes actioned promptly via an electronic care management system.
· Strong safeguarding culture with all staff trained and confident in raising concerns; referrals made to local authority safeguarding team as required.
· Medicines managed via electronic system ensuring correct administration, with missed or refused medicines alerted to management and followed up.
· Exceptional leadership from the registered manager, fostering an open, inclusive, and continuously improving culture with high staff morale and low turnover concerns.
Quality-Statement breakdown (24)
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: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
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: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported, respecting equality and diversityOutstanding
caring: Supporting people to express their views and be involved in making decisions about their careOutstanding
caring: Respecting and promoting people's privacy, dignity and independenceOutstanding
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: 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 empoweringOutstanding
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsOutstanding
well-led: Engaging and involving people using the service, the public and staffOutstanding
well-led: Working in partnership with othersOutstanding
well-led: Continuous learning and improving careOutstanding