Background to this inspection
Updated
15 February 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection was completed by an inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 10 January 2023 and ended on 23 January 2023. We visited the location’s office on 10 January 2023.
What we did before the inspection
We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We sought feedback from the local authority.
We used information gathered as part of monitoring activity that took place on 26 September 2022 to help plan the inspection and inform our judgements.
We reviewed information we had received about the service since they registered with CQC. This included notifications of events providers are required to tell us about, and information from members of the public about their experience of the service.
We used all this information to plan our inspection.
During the inspection
We spoke to 8 people and relatives via telephone to gain feedback about their care. We spoke to 3 care staff including the registered manager. We reviewed a range of records. This included 4 people's care records and medication records. We looked at 4 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including audits, training records and policies and procedures were reviewed.
Following our inspection, we reviewed additional documentation in relation to people's medicines and care records.
Updated
15 February 2023
About the service
Forever Caring is a domiciliary care agency which provides support and personal care to people living in their own home. The service provides support to older adults who may be living with dementia. Not everyone who used the service received personal care. CQC only inspects where people receive personal care, which is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our inspection there were 10 people using the service.
People’s experience of using this service and what we found
People's electronic medicine administration records were not always accurate and medicines weren't always administered as prescribed. People with specific conditions were not always supported by staff who had received training or had their competencies assessed.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
People's care plans were not person centred and did not always provide consistent and clear guidance for staff to meet people's needs.
Systems to check the quality of the service were not in place to identify concerns we found at this inspection. For example, they failed to identify medicine recording errors or the lack of mental capacity assessments.
People were supported by staff they described as 'kind' and 'caring'. People were supported to remain independent and their privacy and dignity was promoted. People felt able to raise concerns.
People were supported to receive care at times they preferred by regular staff. People did not feel rushed and told us staff knew them well.
People felt able to give their feedback on the service and knew who the provider was.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 16 November 2021 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.
We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to safe care and treatment, need for consent, good governance, person centred care and staffing at this inspection.
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.