Date of Assessment: 25 March 2025 to 31 March 2025. The service is a domiciliary care agency registered to provide personal care. People were supported with their personal care needs to enable them to live in their own homes and promote their independence. We carried out a responsive assessment to consider potential risks in relation to governance of the service, training, and recruitment. At the time of the inspection the service supported 50 people with personal care, including older people, people living with dementia, people with sensory impairments and people with neurological conditions. At our last inspection, the provider was previously in breach of the legal regulations in relation to safe care and treatment, safeguarding people from abuse, ensuring fit and proper people were employed, good governance and notifying CQC of incidents. Improvements were found at this assessment and the provider was no longer in breach of these regulations. The service provided safe care, and people were protected from the risk of abuse. Staff understood and managed risks. Staff were recruited safely were appropriately trained and received support and supervision. Medicines were managed safely. People received their medicines as prescribed by staff who were trained and assessed as competent to do so. People’s needs were assessed taking account of people’s communication, personal and health needs. Care plans provided detail of people’s interests, preferences, wishes and health conditions. People were able to access support when they needed it. The staff rota was managed well to ensure people received their care visits without delay. The service monitored people’s health and took action to share any concerns with the wider multidisciplinary teams as required. People were supported to be independent and have choice and control over their lives. People were treated as individuals and staff treated them with kindness, compassion, and dignity. The provider had effective governance and quality monitoring systems in place to identify and drive improvements. Managers and care coordinators were visible, knowledgeable, and supportive, helping staff develop in their roles. People were supported by staff who felt valued by the management team.
PDF cached but not yet analysed by Claude; set ANTHROPIC_API_KEY and re-run .
Expert Care Solutions Ltd Fleet received an overall rating of Requires Improvement at its first inspection in May 2023, with five regulatory breaches identified spanning unsafe medicines management, missed care calls, recruitment failures, safeguarding notification failures, and poor governance. While staff training, nutritional support, and partnership working were strengths, significant concerns remained around care call reliability, medication records, risk assessment gaps, and the registered manager's incomplete understanding of legal responsibilities.
Concerns (14)
criticalStaffing levels: “I never know if they [staff] are coming or not and that means I often don't have anything to eat.”
criticalMissed or late visits: “Staff rostering records showed care staff were sometimes scheduled to attend more than 1 person's care call at the same time.”
criticalSafeguarding: “The omission to provide this person's commissioned care had not been reported to Social Services under safeguarding procedures as required.”
criticalMedication management: “Some people took medicines 'as required', including morphine and paracetamol. There was a lack of PRN protocols as required to guide and inform staff.”
criticalCare planning: “A person's environmental risk assessment and the risk assessment for their outside wheelchair were empty.”
criticalStaff competency: “Overseas staff had a criminal records check from their country of origin, but not a Disclosure and Barring Service (DBS) check as required.”
criticalGovernance: “The provider had failed to submit statutory notifications to inform CQC of 2 safeguarding incidents.”
moderateRecord keeping: “Staff had not recorded the outcome of people's MCA 2005 assessments and best interest decisions, as per good practice guidance.”
moderateConsent / capacity: “Staff did not document the evidence they reviewed when they checked if people had a registered power of attorney.”
moderatePerson-centred care: “They [staff] just talk their own language over the top of me and even do sign language if they think I'm not looking.”
moderateInfection control: “Three people reported staff did not always wash their hands when providing their care.”
moderateIncident learning: “There was no incident record for this missed call and the omission to provide this person's commissioned care had not been reported.”
moderateCommunication with families: “People did not all report they felt listened to. Feedback included, 'They [staff] don't listen and don't want to help.'”
moderateLeadership: “The registered manager, who was also the provider, did not understand all the legal requirements.”
Strengths
· Staff received a range of training based on Care Certificate requirements, updated annually, including specialist training from external healthcare professionals.
· Staff supported people to eat and drink sufficiently and people were positive overall about nutritional support.
· Staff worked with external providers and commissioners in the planning and provision of people's care.
· Staff completed end of life care training and felt supported to care for people at end of life.
· People's care plans included spiritual beliefs, cultural needs, communication needs, hobbies and personal history.
Quality-Statement breakdown (23)
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseRequires improvement
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Using medicines safelyRequires improvement
safe: Preventing and controlling infectionRequires improvement
safe: Learning lessons when things go wrongGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the law
Good
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
caring: Ensuring people are well treated and supported; respecting equality and diversityRequires improvement
caring: Supporting people to express their views and be involved in making decisions about their careRequires improvement
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: 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: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Continuous learning and improving careRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringRequires improvement