Background to this inspection
Updated
3 December 2020
The inspection
This was a focused inspection to check whether the provider had met the requirements of the warning notice in relation to Regulation 17 (Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
Inspection team
The inspection team was made up of two inspectors. The lead inspector carried out the planning of the inspection and spoke with people who used the service and staff. The second inspector carried out a visit to the office location.
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 has not had a manager registered with the Care Quality Commission (CQC) since October 2018. There was a member of staff running the service but they had not registered with CQC. We have referred to them as 'the manager' throughout this report.
Notice of inspection
We gave the service a few days’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider and/or the manager would be in the office to support the inspection.
Inspection activity started on 29 September 2020 and ended on 30 October 2020. We visited the office location on 30 September 2020.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. 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
Prior to the visit to the provider’s office we spoke with one member of care staff, one person who used the service and another person’s relative. We asked the provider to send us a range of records so that we could analyse these away from the provider’s office. Records included care plans, risk assessments, medication records and staff training and supervision records, as well as some policies, the statement of purpose and other records relating to the management of the service.
When we visited the office we spoke with the manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
After the inspection
We continued to receive documentation from the provider, which we analysed along with the other records we had received. This included quality assurance records.
Updated
3 December 2020
About the service
Shield Care Ltd is a domiciliary care service providing personal care to people living in their own homes. At the time of the inspection three people were receiving a service. 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 their relatives were satisfied with the service being delivered by the staff. One relative said, “[The staff] are all wonderful. Without them we don’t know how we’d manage. Our [family member] is very lucky.”
People felt safe with the staff. Staff had received training in a wide range of topics and knew how to keep people safe from harm. Assessments of some potential risks had been completed, including for medicines administration. There were no risk assessments related to COVID-19: we have signposted the provider to resources to develop their approach. Infection control procedures were followed by staff and there were enough staff to meet people’s needs.
The service does not have a registered manager in post. Although auditing of various aspects of the service had improved there were still further improvements to be made, especially in the records. Quality assurance processes included seeking the views of people who used the service and their relatives. The provider did not fully understand their legal responsibilities and had failed to display their rating.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was inadequate (report published 18 February 2020), there were multiple breaches of regulation and the service was in Special Measures. We issued the provider with a warning notice stating they must make the improvements by 30 April 2020. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
This service has been in Special Measures since February 2020. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures. The provider had met the requirements of the warning notice and was no longer in breach of regulations.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection. We planned to carry out a targeted inspection to check whether the Warning Notice we previously served in relation to Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. We inspected and found there had been improvements in a number of areas of the service being provided. We widened the scope of the inspection to become a focused inspection which included the key questions of safe and well-led.
We did not inspect the other key questions. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Shield Care Ltd on our website at www.cqc.org.uk.
The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.
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.
Since the last inspection we recognised that the provider had failed to display their rating. This was a breach of regulation. Full information about CQC’s regulatory response to this is added to reports after any representations and appeals have been concluded.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.