Date of assessment: 7 January to 16 January 2026. This service is a domiciliary care service providing personal care for people living in their own homes in the community. They provide support to people with a range of different needs including older people, people with dementia and people with physical disabilities. At the time of the assessment 5 people were using the service who were receiving the regulated activity of personal care. Not everyone who uses a domiciliary service receives personal care. CQC only inspects where people receive personal care. We rated this service under our previous methodology in March 2023 where it was inspected and rated as good overall. At this assessment we reviewed all 5 key questions and rated the provider good overall. Care records were completed in collaboration with people and their relatives. People felt included in decisions around their care. Care plans included person-centred details about people needs and included people’s areas of interest and history. Staff received training to support them to do their jobs well. Staff felt supported in their roles and spoke positively about working for the service. Recruitment was completed safely with pre-employment checks taking place in line with current requirements. Policies and processes were in place to keep people safe from harm. Staff were training in safeguarding and understood their role and responsibilities in relation to this. Records evidenced that people were asked feedback about their care and support regularly. Managers completed regular audits and governance of the service to ensure care was delivered safely and to identify and address issues quickly.
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Safer Staffing Solutions Ltd improved from Inadequate to Good across all five key questions following a previous inspection that found multiple regulatory breaches, and has exited Special Measures. All previously identified breaches of regulations relating to medicines, staffing, recruitment, care records, complaints and governance have been remedied.
Strengths
· Significant improvement from previous Inadequate rating and Special Measures, with all regulations now complied with
· Safe medicines management with regular MAR audits, competency checks and clear PRN/topical guidance in care records
· Safe recruitment procedures including DBS checks, references and proof of identity now in place
· Sufficient staffing with electronic monitoring system tracking call times and alerting to delays or short calls
· Person-centred care records regularly reviewed and updated to reflect changes in needs and preferences
Safer Staffing Solutions Ltd, a Sheffield domiciliary care agency supporting 13 people, was rated Inadequate overall at its first CQC inspection in July 2022, with breaches across six regulations including safe care and treatment, staffing, fit and proper persons employed, person-centred care, complaints handling, and good governance. Critical failures included chronic understaffing (two care workers covering ~300 hours/week), frequent missed and late visits, unsafe medicines management, absent staff supervision and training records, and ineffective quality assurance systems, placing the service into special measures.
Concerns (14)
criticalMedication management: “Sometimes I only get five instead of six, when I really need all six”
criticalMedication management: “There were no records of regular audits of medicine administration records (MARs).”
criticalStaffing levels: “they currently employed two care workers to cover approximately 300 hours of care per week.”
criticalMissed or late visits: “Three times in the last three weeks the care worker has not turned up. Once the care worker came to the door at 11pm.”
criticalStaff training: “The staff do not seem to know how to insert a catheter or maintain it correctly.”
criticalRecord keeping: “The registered manager had failed to maintain an accurate, complete and contemporaneous record in respect of each service user.”
criticalGovernance: “The registered manager had not established effective quality assurance processes...medicines audits had not identified the lack of PRN guidance for staff.”
criticalIncident learning: “Accidents and incidents were not always recorded...There was no analysis of accidents or incidents to help keep people safe.”
criticalPerson-centred care: “My relative should have two care workers four times a day but sometimes only one care worker shows up...my relative ended up on the floor.”
moderateSupervision / appraisal: “There were no records of staff receiving support and professional development through supervisions or appraisals.”
moderateCare planning: “Care records were not person-centred. They contained little information about the person's life history, their strengths or preferences.”
moderateComplaints handling: “My relative and I have made two calls about issues such as towels and training and neither have been responded to.”
moderateEnd-of-life care: “The care workers do not seem to have had any training in palliative care which is the care my relative needs.”
moderateStaff competency: “My relative is always being asked what needs to be done and where things are, and that should be part of their training.”
Strengths
· Staff had received safeguarding training and were confident concerns would be acted upon; one safeguarding concern had been appropriately raised with the local authority.
· PPE was available to staff and infection prevention and control policies were in place.
· People were supported to access health and social care services, including GP and social worker involvement.
· Most people and relatives described care staff as kind, friendly and caring.
· The registered manager liaised with other health and social care professionals regarding changes to care and support needs.
Quality-Statement breakdown (20)
safe: Using medicines safelyInadequate
safe: Staffing and recruitmentInadequate
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongInadequate
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Preventing and controlling infectionGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawInadequate
effective: Staff support: induction, training, skills and experienceInadequate
effective: Supporting people to eat and drink enough to maintain a balanced diet
Requires improvement
effective: Staff working with other agencies to provide consistent, effective, timely care; Supporting people to live healthier livesRequires improvement
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
caring: Respecting and promoting people's privacy, dignity and independenceRequires improvement
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
responsive: Improving care quality in response to complaints or concernsInadequate
responsive: Planning personalised care to ensure people have choice and control; End of life care and supportRequires improvement
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships; support to follow interests and activitiesGood
well-led: Managers and staff being clear about their roles; quality performance, risks and regulatory requirements; Continuous learningInadequate
well-led: Engaging and involving people, the public and staff; Working in partnership with othersInadequate
well-led: Promoting a positive culture; duty of candourRequires improvement