Date of assessment: 21 October 2025 to 11 November 2025. Fortune Smiles Service Ltd is a domiciliary care agency and is based in the London Borough of Redbridge. The service provides personal care to people in their own homes. 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. This inspection was prompted by a review of the information we held about this service. As a result, we undertook a responsive inspection to review the key questions of Safe, Effective Responsive and Well-Led only. The inspection team consisted of 1 inspector. During the assessment, we looked at 28 quality statements. We carried out a site visit to the service on 24 October 2025. Our assessment was announced. This means we gave the service 48 hours' notice prior to our visit taking place because staff were often out of the office providing care to people. We needed to be sure that they would be in. 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. We spoke with the director, 9 staff, 2 people living at the service and 1 relative.
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Fortune Smiles Service Ltd received an overall rating of Requires Improvement at its first CQC inspection, with breaches of Regulation 11 (consent/MCA) and Regulation 17 (good governance) identified due to incomplete risk assessments, absent MCA assessments, non-person-centred care plans, and lack of completed audits. The service demonstrated strengths in its caring approach, infection control, recruitment practices, and staff training and supervision.
Concerns (6)
criticalCare planning: “Robust risk assessments had not been completed in full relation to a person's health conditions to ensure risks associated with their medical conditions were minimised.”
criticalConsent / capacity: “Where people may not have capacity to make decisions about their care and treatment, an MCA assessment had not been carried out to determine if they had capacity.”
criticalGovernance: “Audits had not been completed yet as the service completed audits periodically. As audits had not been completed, this meant shortfalls could not be identified.”
criticalRecord keeping: “Failure to maintain accurate, complete and contemporaneous records for each service user meant that service users were at risk of receiving unsafe and inappropriate care.”
moderatePerson-centred care: “A person's care plan did not include their preferences on how they would like to be supported with personal care and did not detail the type of support they required.”
minorCommunication with families: “The communication plan did not detail how and when the materials should be used to ensure communication was always effective.”
Strengths
· Staff were trained in safeguarding and understood how to protect people from harm; people reported feeling safe.
· Systems were in place to minimise risks of late or missed calls; a person confirmed staff were always on time.
· Pre-employment checks including DBS, references and right-to-work checks had been completed for all staff.
· Staff had received training in essential areas including safeguarding, basic life support and moving and handling.
· Regular supervisions were carried out and staff reported feeling supported by management.
Quality-Statement breakdown (20)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Learning lessons when things go wrongGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Preventing and controlling infectionGood
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawRequires improvement
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
caring: Ensuring people are well treated and supported; 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; Meeting people's communication needsRequires improvement
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportNot rated
well-led: Managers and staff being clear about their roles; governance; duty of candourRequires improvement
well-led: Engaging and involving people using the service, the public and staff; continuous learningGood