Background to this inspection
Updated
30 December 2022
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 carried out by an inspector and two Experts 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 1 November 2022 and ended on 14 November 2022. We visited the location’s office on 1 November 2022.
What we did before the inspection
We reviewed information we had received about the service. We also looked at notifications about important events that had taken place in the service, which the provider is required to tell us by law. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
We contacted health and social care professionals to obtain feedback about their experience of the service. These professionals included local authority commissioners and the safeguarding team as well as Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. Healthwatch told us they did not have any information about the service. We used all of this information to plan our inspection.
During the inspection
We spoke with 12 people who used the service and five relatives and a person’s visitor about their experience of the care provided. We spoke with seven members of staff including care staff, senior care staff, office staff, the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included seven people's care records and multiple medicines records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including audits, risk assessments and procedures were reviewed.
Updated
30 December 2022
About the service
Curant Care – Ashford is a domiciliary care service providing personal care to 41 younger adults with physical disabilities and adults aged 65 and over. At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. Not everyone who used the service received personal care. 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.
People’s experience of using this service and what we found
People and relatives had mixed views about the service. Some relatives shared positive experiences, and some had negative experiences. Comments included, “They do not have the courtesy to tell you they are running late and can’t attend. I don’t get information about who is coming and what time. [Staff member] is lovely, she has care and compassion”; “I feel I am in safe hands”; “I feel my loved one is in good hands and its peace of mind for me and enables me to carry on working, they really look after them” and “I feel very safe with them, some of the carers need more prompting than others, on the whole they are very good.”
Risks to people's safety had not always been identified. Risk assessments did not have all the information staff needed to keep people safe. Care plans did not always contain up to date information about people’s medicines. It was not always clear which medicines people were prescribed. This meant staff did not have all the information they needed to provide safe care.
The provider had not ensured that staff were deployed sufficiently to meet people's assessed needs. People and relatives told us about issues from erratic call times, staff lateness and care visits being cut short because staff were rushing to get to the next care visit.
The service was not always well led. The provider had not carried out the appropriate checks to ensure that the quality of the service was maintained. The provider had failed to identify issues relating to risk management, medicines management, staff deployment and designing and providing care to meet people’s needs we had identified.
Prior to people receiving a service their needs were not always thoroughly assessed. People’s oral care, medicines and health needs were not always included in the information obtained before packages started to enable staff to provide safe, person-centred care and support. We made a recommendation about this.
The provider had an up to date infection prevention and control (IPC) policy. Staff had completed IPC training. Staff had access to enough personal protective equipment (PPE), however staff did not always wear PPE to keep themselves and people safe.
Staff had completed mandatory training; however, the provider’s training records did not evidence that staff had completed additional training to meet people’s assessed needs such as, diabetes, skin integrity and Parkinson’s disease.
Care plans were in place which provided a list of tasks for staff to complete. These were not always person centred or detailed enough to show new staff what all the tasks were. People and their relatives told us staff knew their needs and preferences well. They told us they had been involved with the care planning process.
People and relatives knew how to complain. Some people and relatives who had complained said changes had been made following their complaints. However, some people and relatives felt they were not always listened to as the same issues kept occurring. We made a recommendation about this.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
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 18 August 2022 and this is the first inspection.
Why we inspected
The inspection was prompted in part due to concerns received about staff deployment and medicines practice. A decision was made for us to inspect and examine those risks.
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 medicines management, risk management, staff deployment, designing care and treatment to meet needs and quality monitoring at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.