This targeted inspection of Supreme Care Services Limited examined safeguarding systems following seven reports concerning potential financial abuse risk, finding no evidence that people were at risk of harm. The provider had effective financial oversight processes, trained staff, and robust safeguarding learning systems in place; the previous overall Good rating was unchanged.
Strengths
· Effective processes in place to protect people from the potential risk of financial abuse, with clear policies managed in partnership with the local authority
· Staff trained on safeguarding and knew the process to report and escalate concerns
· Regular updates sent to people and care staff to inform them of how to protect themselves from potential abuse
· Safeguarding discussed in team meetings and supervisions; senior staff reviewed all safeguarding concerns monthly to ensure lessons learned were identified and shared
Supreme Care Services Limited, a domiciliary care agency supporting 520 adults in London, was rated Good overall at its May 2022 inspection, with all four assessed key questions rated Good and the Responsive rating improved from Requires Improvement at the previous 2019 inspection. Minor recruitment record-keeping gaps were identified, resulting in a recommendation to review employment practices, but no regulatory breaches were found.
Concerns (3)
minorRecord keeping: “The providers application form stated that all volunteer roles should be recorded but on one occasion it was blank despite one-person having a reference from a volunteering role.”
minorGovernance: “Within another person's file we identified evidence they had other employment which they had not declared within their employment history.”
minorComplaints handling: “Their policy stated that they would make the complainants aware of the investigation outcome. Senior staff explained this was done but only if the complaint was raised directly with them.”
Strengths
· People benefited from consistent staff and carers attended calls on time, confirmed by electronic call monitoring data across 560 people.
· Detailed risk assessments were completed for all people including moving and handling, falls management, medicines and specific health conditions.
· Medicines were administered safely by trained and competency-assessed staff, with 10% monthly MAR chart audits.
· Staff received induction, shadowing, three supervision sessions and an annual appraisal each year.
· Provider operated an accredited befriending scheme to address social isolation and loneliness.
Quality-Statement breakdown (19)
safe: Staffing and recruitmentGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; supporting people to eat and drink enoughGood
effective: Staff support: induction, training, skills and experienceGood
effective: Staff working with other agencies; supporting people to access healthcareGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
responsive: Planning personalised care to ensure people have choice and controlGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to maintain relationships and avoid social isolationGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles; continuous learning and improving careGood
well-led: Engaging and involving people, promoting a positive person-centred cultureGood
Supreme Care Services Limited, a London domiciliary care agency supporting 302 adults, was rated overall Good at its first inspection in February/March 2019, with strengths in safeguarding, recruitment, caring practice and quality assurance. The Responsive domain was rated Requires Improvement due to persistent difficulties people and professionals experienced in reaching the office and obtaining timely responses, and staff also showed limited understanding of Mental Capacity Act principles.
Concerns (4)
moderateCommunication with families: “"It's not easy to get hold of the people in the office. It can just ring out for ages...I've had to phone a couple of times about things and I'm still waiting for them to get back to me."”
moderateConsent / capacity: “Most staff that we talked to had a very limited knowledge about the MCA. They couldn't tell us what the MCA was in relation to but when prompted they provided examples.”
moderateMissed or late visits: “"I've had where they weren't turning up until 9.30am and it should be 8am and they don't let me know...I have had times where nobody has come at the weekends."”
minorInfection control: “"[Staff] just wear ordinary clothes and they have no name or identity badge...There have been times when they say they have forgotten the gloves and I have to give them gloves."”
Strengths
· Comprehensive, person-centred risk management plans with colour-coded alerts for higher-impact risks
· Robust safe recruitment procedures including DBS checks, references, and right-to-work verification
· Staff described by people as kind, caring and respectful of privacy, dignity, culture and religion
· Regular supervision every three months with agreed follow-up dates and signed records
· Quality assurance processes including regular audits, spot checks, and incident/complaint monitoring
Quality-Statement breakdown (18)
safe: Safeguarding systems and risk managementGood
safe: Recruitment proceduresGood
safe: Medicines managementGood
safe: Staff punctuality and missed visitsRequires improvement
safe: Infection control and uniform complianceRequires improvement
effective: Nutrition and healthcare professional involvementGood
effective: Staff training and supervisionGood
effective: Mental Capacity Act knowledge and applicationRequires improvement
caring: Kindness, dignity and respectGood
caring: Promotion of independenceGood
caring: Cultural and spiritual sensitivityGood
responsive: Communication with people and familiesRequires improvement
responsive: Care planning and person-centred recordsGood
responsive: Complaints handlingGood
responsive: Accessible information and communication needsGood