Jayrima Care Limited

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

People and relatives shared positive feedback about the care received. One person said, “They are quite caring, you are more than just a number.”

Improvements were still required in the areas highlighted at the last inspection.

Risks to people’s care were not always well documented in their risk assessments and care plans.

There was no evidence medicines were not administered safely, however there were still several issues with the quality of medication records. The provider was not always following their own medication policy or best practice guidance and regulations.

Recruitment processes did not always evidence that robust checks had been done to ensure staff were safe to work with vulnerable people.

Staff had completed some but not all their mandatory training and assessment of competencies. The registered manager told us staff were offered ongoing support via the phone and regular team meetings, but no formal supervisions had been completed.

We found lack of evidence of an effective quality assurance process in place to identify the issues found during our inspection and to drive the necessary improvements.

Staff and the registered manager were knowledgeable about identifying and reporting safeguarding concerns. The provider ensured staff followed safe infection control practices and had enough personal protective equipment (PPE). People were protected from the risk of infection and plans were in place to mitigate the increased risks from the current Covid-19 pandemic.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 9 June 2019) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found not enough improvements had been made and the provider continued in breach of regulations.

Why we inspected

We carried out an announced comprehensive inspection of this service on 20 May 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve their good governance and staffing arrangements.

We undertook this targeted inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the some of the key questions in the Safe, Effective and Well-led domains which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained requires improvement.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Jayrima 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 continued to find breaches in relation to good governance and staffing at this inspection.

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

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.

People’s experience of using this service:

Whilst we found no evidence to suggest medicines were not administered safely, issues were noted with some records related to medicines management. For example, hand written medicine entries on the administration records had not always been transcribed accurately. Risks to people were assessed but some risk assessments were either not required or did not contain sufficient information.

There was no staff training programme or support to enable them to perform their roles effectively. There was a recruitment processes in place but some of the information relating to safe recruitment had not been documented.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff gained people's consent before providing support. Although, mental capacity assessment or best interest decisions had not been completed for one person.

There was a system in place to respond to any complaints, however, not all information was documented. There was no effective system in place to monitor the quality of service and identify areas for improvement.

There were enough staff to meet people’s needs. An induction was completed by all staff.

People told us they felt safe and staff knew how to respond to possible harm. Staff followed infection prevention and control practices when supporting people in their own homes.

Staff involved healthcare professionals to ensure people's health care needs were met. People received support with eating and drinking, when required.

People and relatives said staff were reliable, kind and caring. Staff understood how individual people preferred their care and support delivered and the importance of treating people with dignity and respect. People's care plans were personalised, with enough detail for staff to provide effective care and support.

People and relatives had the opportunity to provide feedback on the service received. Information was provided so people knew who to speak with if they had concerns.

Rating at last inspection: The service was registered in June 2018, and this was the services first inspection.

Why we inspected: This was a planned inspection based on when the service was registered with the Care Quality Commission.

Enforcement: We identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 around staffing and good governance. Please see the ‘action we have told the provider to take’ section towards the end of the report. We also recommended the provider considers guidance and best practice on the Mental Capacity Act 2005, in relation to people who lack capacity, and act to update their knowledge and documentation appropriately.

Follow up: We will continue to monitor the service through information we receive. Further inspections will be planned for future dates as per our re-inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk