Date of Assessment: 15 April 2025 to 14 May 2025. The service provides support to children, younger and older adults in their own homes. They specialise in care for those people with complex physical health needs, mental health conditions, physical disabilities, learning disabilities, autism, sensory impairments and dementia. We assessed the service due to information we had about the service regarding staffing levels, staff training and safe care and treatment. The provider fostered a learning culture, actively seeking feedback and making improvements. People, families, and staff felt confident raising concerns and were assured the provider listened and acted. The service maintained safe systems, working with individuals and healthcare professionals to manage care transitions and risks. Safeguarding remained a priority, with policies protecting individuals while promoting independence. Risk assessments guided staff in supporting people with complex health conditions. Safe environments were upheld through effective use of technology and equipment. Staff received comprehensive training. Workforce development included lived experience training which enhanced staff’s understanding of people’s needs. Care remained effective, with holistic assessments and regular reviews reflecting people’s individualised needs. Staff supported people in maintaining health and independence, collaborating with healthcare professionals to ensure positive outcomes for people. A culture of kindness, inclusion, and respect was promoted within the service which supported person-centered care. While staff felt supported, some concerns about scheduling were raised, which leaders were aware of and had taken action to address. Governance was largely effective, with a minor shortfall in recruitment oversight promptly rectified and action taken to reduce risk of recurrence. The provider maintained strong leadership, fostering an inclusive and collaborative environment where staff felt valued and supported. The provider engaged proactively in partnership working, ensuring care was well-coordinated and responsive to individual needs. Professionals reported positive collaboration, reinforcing safe, person-centered care. We expect health and social care providers to guarantee autistic people and people with a learning disability respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people; and providers must have regard to it. We found people received care and support in accordance with the principles of this guidance.
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Highlands Care Solutions, a domiciliary care agency supporting 41 people, was rated Good across all five key questions at this first inspection. The service demonstrated safe, effective, caring, responsive and well-led care with an innovative vision for using technology to improve homecare, with only minor reports of occasional lateness due to travel or overrunning calls.
Concerns (1)
minorMissed or late visits: “Some people reported that staff were occasionally late because of travel problems or a previous call overrunning, but there were no reports of missed calls.”
Strengths
· Robust safeguarding systems with staff trained and confident to escalate concerns; received compliment from safeguarding professional for detecting financial abuse
· Safe recruitment processes including DBS checks and verbal follow-up of written references
· Effective medicines management with competency checks, body maps for creams, and prompt response to missed medicine alerts
· Person-centred care plans producing good outcomes (e.g. support package reduced from 70 to 5 hours/week)
· Strong induction based on the Care Certificate with shadowing of experienced staff
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; supporting people to live healthier lives, access healthcare services and supportGood
effective: 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: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportNot rated
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 careGood