Background to this inspection
Updated
21 September 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team
The inspection was conducted by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was a registered manager in post, who was also the owner of the agency.
Notice of inspection
This inspection was announced. We gave the service two days’ notice of the inspection. This was because it is a small service and we needed to be sure that the registered manager would be in the office to support the inspection.
Inspection activity commenced on 26 April 2022 and concluded on 14 June 2022. We visited the office location on 26 April 2022.
What we did before the 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. We looked at information we hold about the service such as notifications for significant events and the last inspection report. We used all this information to plan our inspection.
During the inspection
We spoke with the registered manager, a supervisor and a voluntary administration assistant. We reviewed a range of records, which included the care plan for the one person using the service. We checked the files for two staff members in relation to their recruitment, training and development, supervision and appraisal. We looked at a range of policies, procedures and other records in relation to the management of the service.
After the inspection
We continued to seek clarification from the registered manager to validate evidence found. We requested and reviewed additional documents including evidence of medicines training for care staff, which was not available during the inspection site visit. We spoke with a relative of the person using the service. The person who uses the service was not able to communicate with us by telephone. We contacted both care workers and received a response from one of them, who was not able to speak fluently on the telephone with us. We remotely held a meeting with the registered manager on 23 May 2022 to provide feedback. During this meeting we informed the registered manager that we had not received a response from one of the care workers. We wrote to the registered manager and sought confirmation that she had commenced actions to improve the quality of the service. A second remote meeting was held with the registered manager on 14 June 2022 to discuss the concerns found at this inspection.
Updated
21 September 2022
About the service
Imaan Care is a domiciliary care agency located in the London Borough of Hammersmith and Fulham.
Not everyone using the service received support with tasks related to personal care and eating. CQC only inspects services where people receive this type of care and support. We also consider any wider social care provided.
At the time of the inspection, the service was providing a personal care service for one person with complex health care needs.
People’s experience of using this service and what we found
People were not being protected from the risk of harm because risk assessments were either absent or incomplete and out of date.
Safe recruitment practices were not always undertaken to make sure staff were suitable to work with vulnerable people.
People's health care needs were not understood by the registered manager and staff were not provided with the guidance and training they needed. This included the absence of safe support guidance for eating and drinking.
Staff supported people to take their medicines where this formed part of an agreed package of care. However, robust recording systems were not in place to support safe medicines practices.
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. However, the policies and systems in the service did not always fully support this practice.
The registered manager was not carrying out effective quality assurance checks and was not identifying the concerns for people's safety that we identified. We did not find satisfactory improvement since the last inspection.
For more details, please see the full report which is on the CQC website www.cqc.org.uk
Ratings at the last inspection and update
The last rating for this service was requires improvement (published 29 October 2019). At this inspection the rating had deteriorated to inadequate.
Why we inspected
This inspection was prompted by a review of the information we held about the service.
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 have identified ongoing breaches in relation to recruitment, risk assessments, medicines management, staff training and support and quality assurance processes.
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
The overall rating for this service is ‘Inadequate’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the 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.