Archived: Short Notice Care Services

Updated 22 October 2021

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 Care Act 2014.

Inspection team

This inspection was carried out by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service did not have a registered manager. This meant the provider alone is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 24 hours' notice of the inspection. This was because we needed to be sure there would be service representative in the office to support the inspection.

Inspection activity started on 24 March 2021 and ended on 31 March 2021. We visited the office location on 25 March 2021.

What we did before the inspection.

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who worked with the service. We also contacted Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with five people who used the service and five people’s relatives about their experience of the care provided. We spoke with seven support staff, three staff who worked in a supervisory role, the deputy manager and the manager.

We reviewed a range of records. These included three people's care records and two staff files in relation to recruitment and staff supervision. We also looked at variety of records relating to the management of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We spoke with the nominated individual (a person nominated by the provider to be accountable for the service provision).

Updated 22 October 2021

About the service:

Short Notice Care Services is a domiciliary care agency providing personal care to people in their own homes. The service was supporting 34 people with personal care in their own homes at the time of our inspection.

People's experience of using this service and what we found

We found widespread shortfalls in the way the service was monitored at a provider level. Unpaid bills meant that services such as the rental of phones and printers had been withdrawn. This had negatively impacted upon the service provided.

The lack of governance and audits meant the provider did not know if staff met people’s needs or delivered safe and effective care. The registered manager had left the service in December 2020 and the provider had not implemented management support for the service in a timely manner. This meant there was a period of time where the service was not monitored and this had impacted upon the quality of the service provided, despite staffs’ best efforts.

Some people were supported by staff to take their medicines and although overall they did this safely there were occasions when people ran out of medicines and this was not immediately resolved. This placed people at risk of harm. Staff did not have all the information they required to ensure people’s medicines were administered safely and there was a lack of monitoring to ensure processes were followed and were safe. Following the inspection visit we raised a safeguarding after identifying a lack of medication monitoring could have negatively impacted upon one person’s wellbeing.

People told us they felt safe while being supported with their personal care and all commented that staff knew them well and ‘went the extra mile’ to ensure their calls happened and their needs were met.

Risks relating to people’s safe care and support had been considered by staff and the majority were documented. Not all information had been recorded to direct staff how to safely manage issues identified. For example, staff had no written direction for how to monitor pressure areas when a person was at risk of their skin breaking down. There was no evidence that the lack of recording had impacted on the quality of care provided.

Staff were safely recruited however documentation did not always reflect that required checks had been carried out, or documented, to reflect safe practice. These shortfalls had been identified by staff who were taking action to update records.

We have taken action to address issues identified.

Rating at last inspection

The last rating for this service was good. The inspection took place in April 2019.

Why we inspected

We had received concerns from social care professionals that suggested there were issues with the financial viability of the service, and this would potentially have an impact on the service provided. Our findings reflected the concerns shared with us.

We reviewed the information we held about the service. We did not inspect the key questions of effective, caring and responsive which were previously rated as good.

The overall rating for this service has changed from good to inadequate. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Short Notice Home Care on our website at www.cqc.org.uk.

Enforcement

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment and in the governance of the service.

Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is 'Inadequate' and the service is therefore in 'special measures'. This means we will keep the service under review and, if we do not propose to cancel the provider's registration, we will re-inspect within six months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service.

This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.