Vision Care Services is a domiciliary care service which provides care and support for people in their own homes. Not everyone who used the service received personal care. 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. At the start of the inspection the service was supporting 196 people with personal care. Due to changes implemented by Bradford Council by the end of the inspection the service was supporting 149 people.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people 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.
Right Support:
Medicines were not being safely managed. Risks to people were not always consistently or effectively managed. We found multiple risk assessments were not in place for people where needed. Staff had not received all the necessary training to enable them to provide safe and person-centred care appropriate to people’s specific medical conditions.
People were being safeguarded from the risk of abuse as staff were reporting concerns and these were being acted on by management.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Right Care:
Care plans were detailed relating to people’s preferences for care call activities, however where people had specific health needs the care plans did not provide guidance to staff on how these conditions affected people or how they should support them safely.
People and relatives told us they were very happy with the care being provided by the service.
The service was working effectively with external professionals.
Right Culture:
The provider did not have safe and effective systems in place to monitor, review and improve the quality of care provided. The shortfalls found on inspection had not been identified by the provider during their internal audit processes.
We were not assured lessons were being learnt due to ineffective audit systems.
Staff were compliant with infection prevention and control measures and procedures, and the provider had sufficient supplies of personal protective equipment.
The provider was very proactive with gaining feedback from people, relatives and staff and engaged with them regularly to review their view of the care being received.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was good (published 20 November 2018).
Why we inspected
We undertook this inspection as part of a random selection of services rated Good and Outstanding.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Vision Care Services on our website at www.cqc.org.uk
Enforcement
We have identified breaches in relation to medication management, staff training, managing risks and good governance at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.
