Archived: Civicare Midlands Ltd

Updated 13 May 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 15, 16 and 17 November 2016 and was announced. We gave the provider 48 hours' notice of the inspection because it is a domiciliary care agency and we needed to be sure that the registered manager and staff would be available to speak to. The inspection team consisted of one 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.

As part of the inspection we reviewed the information we held about the service. We looked to see if statutory notifications had been sent by the provider. A statutory notification contains information about important events which the provider is required to send to us by law. We sought information and views from the local authority. We also reviewed information that had been sent to us by the public. We used this information to help us plan our inspection.

As part of the inspection we spoke with 11 people who used the service and eleven relatives. We met with two of these people and one relative in their own home to discuss the care they received from the service. We spoke with the provider who also held the role of the registered manager. We spoke with the deputy manager and five members of staff including the care supervisors, the care coordinator and care staff. We also spoke with one social care professional. We reviewed six people's care records including their medicine administration records, nine staff files and records relating to the management of the service.

Updated 13 May 2017

This inspection took place on 15, 16 and 17 November 2016 and was announced. At the last inspection completed 19 May 2016 the provider was not meeting a number of the regulations we inspected. The provider was not submitting notifications to CQC about significant events such as injury as required by law. The provider was also not meeting the regulations regarding providing person-centred care, safe care, responding to complaints, ensuring care staff were safely recruited for their roles and effective management of the service. At the inspection completed in November 2016 we found the provider had made improvements and was now meeting the regulations around providing safe and person-centred care. They had however failed to make sufficient improvements overall to improve the service and remained in breach of multiple regulations.

Civicare Midlands Ltd is a domiciliary care agency that is registered to provide personal care. At the time of the inspection the service was providing support to 42 people living in their own homes. Most of these were older people or people with a disability. There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were not protected from potential abuse as the provider did not ensure both they, the staff and management team were managing safeguarding concerns safely. People were not protected from harm due to unsafe recruitment practices. People were supported by sufficient numbers of staff and we found improvements had been made to the times at which people received their care visits. People were happy with the support they received with their medicines. However, some improvements were still needed in the safe management of medicines.

People’s rights were not always upheld by the effective application of the Mental Capacity Act 2005. People told us the skills of the staff team had improved, however, we identified further areas of improvement were needed. People were happy with the support they received with their food and drink and most people’s day to day health was maintained.

People told us care staff were mostly kind and caring however this was not always consistent across the whole staff team. People were supported to make choices about their care. However care staff did not always understand how to make choices in people’s best interests where they lacked capacity to make these decisions. People were cared for in a dignified way and their independence was promoted.

Most people told us they received care that met their needs and preferences. The provider had not always identified where some people still did not receive care that met their needs. People told us the provider’s response to complaints had improved but further improvement was still required.

People were cared for by a staff team who felt supported by the management team. However, people were not protected by a quality assurance system that identified the areas of improvement needed within the service. We found significant failings in the provider’s ability to understand and recognise when care provided did not meet the required standards. The provider did not have an understanding of their legal requirements or the expected standards of providing consistently good, safe care to everyone using the service.

We found the provider was not meeting the regulations around safeguarding people from abuse, safe recruitment of care staff, consent to care, managing complaints, effective management of the service and submitted statutory notifications to CQC. You can see what action we told the provider to take at the back of the full version of the report.

At the last inspection completed in May 2016, we rated the provider as ‘inadequate’ and the service was placed into special measures. The overall rating for this service at this inspection is ‘Inadequate’ and the service therefore will remain in ‘Special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their 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.