Archived: ProCare Solutions

We undertook this focused inspection on 8 June 2017 due to receiving information of concern and to check if the provider had taken any action following our last inspection to drive improvement. This report only covers our findings in relation to the safety and welfare of people. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for ProCare Solutions on our website at www.cqc.org.uk

This service provided care in people’s homes in the South Staffordshire area to older people. At the time of the inspection 12 people were being supported by the service.

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 we visited did not receive their agreed levels of support and calls were missed by the provider. When calls had been missed we had not received notification of these incidents in line with our requirements. We could not be sure the provider was open and transparent with us as we received differing information about the people they supported and the hours they delivered, potentially placing people who used the service at risk.

When individual risks had been identified for people we could not be assured staff had the training or information to keep them safe. Risks assessments and care plans were not always in place as required. When people needed support with medicines we could not be sure people had received these as required as tablets were found in previous supplies of blister packs.

The overall rating for this service is 'Inadequate' and the service is therefore 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, it 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

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Full information about CQC's regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

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 did not always receive their agreed levels of support as there were not always sufficient staff available. Staff told us they felt overworked as they were tired and stressed. The provider was unclear on the amount of care hours they needed to deliver to people. We could not be assured the provider had a suitable system in place to ensure staffs suitability to work within people’s homes. As staff felt rushed we could not be assured people were supported in a caring way.

The systems that the provider had put in place to monitor the quality of the service were not effective in identifying areas of concern. This information was not used to drive improvements. The provider had not identified when incidents should be reported and documented and no review of these had taken place. The provider had sought the opinions from people who used the service however this information had not been used to bring about change when necessary. Staff did not feel listened to and there was no evidence that staff had the opportunity to raise concerns as supervisions were not always taking place. When complaints had been made the provider had not responded to these in line with their own procedures.

Staff received an induction and training however this was often after they had started working in people’s homes. Due to the staffing shortfalls staff did not receive protected time to attend training. There was no evidence available that staff competencies were assessed and staff gave medicines to people without having their knowledge of this checked to ensure they were safe to do so. When people needed as required medicines there was no guidance in place for staff to follow to ensure this was administered correctly.

People and relatives were happy with the staff. People’s privacy and dignity was maintained and they were encouraged to be independent. Risks to people were identified and staff had the information available to support people accordingly. When needed people were offered support with hobbies and meal preparation. People managed their own healthcare needs however staff received support from the office and acted accordingly when needed.

People felt involved with the planning and reviewing of their care and were happy with how they received their medicines. When needed peoples mental capacity had been assessed and decisions were being considered in people’s best interests. We found staff knew how to recognise and report potential abuse and knew the procedure to follow for whistleblowing.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.