Archived: We (Always) Care Limited

We Always Care Ltd is a domiciliary care service providing personal care to people aged 65 and over. At the time of our inspection the service was supporting seven people.

Not everyone who used the service may receive 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

Management oversight of the service needed further improvement. Whilst the provider had introduced some systems to check the quality of the service provided since our last inspection, further improvements were required for the monitoring of the service and staff support systems. There was no registered manager in post at the time of our inspection.

People’s relatives and friends told us they were protected from risks to their safety. People were supported by staff who knew when to report concerns and managed any identified risks. People were supported to receive their medicines as prescribed and quality assurance tools in place supported this process.

People were supported by sufficient staff who had been safely recruited.

People’s relatives were satisfied with the care people received. People's care records had improved since the introduction of a new electronic recording system and now showed actions staff took to provide effective care.

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 requires improvement (published 11 October 2019). There were multiple breaches of regulation in relation to the safe administration of medicines, staff recruitment and governance. The provider completed an action plan after our last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made to systems for management of medicines and staff recruitment. However, despite some improvement in governance the provider remained in breach of Regulation 17 HSCA RA Regulations 2014 (good governance). The service remains rated requires improvement. The service has now been rated as requires improvement for two inspections.

Why we inspected

We received concerns in relation to staffing and governance. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has remained unchanged. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the well led section of this full report. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for We Always Care Ltd 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 have identified a continued breach in relation to good governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We (Always) Care Limited is a domiciliary care service. It was providing personal care to 10 older people and younger adults at the time of the inspection.

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 were not fully protected from risks to their safety. Despite staff knowing when to report concerns they had failed to do so on one occasion. Identified risks to people were not always managed, reviewed or updated with the actions taken. People’s medicines were not managed safely. Staff competence and training to administer medicines was not up to date. The provider’s recruitment processes did not fully meet regulatory requirements.

People’s holistic care needs were not always assessed when planning their care. Staff had not always received up to date training before they supported people. Staff and the provider had a limited understanding of how to support people to make decisions when they did not have capacity. However, people were happy with the care they received. People's care records did not always show the actions staff had taken to provide effective care.

There was poor management oversight of the service. The provider had no effective systems to check the quality of the service provided or to monitor staff practice and competence. There was no registered manager in post and the provider did not fully understand the regulatory requirements in providing the service.

People were supported to access healthcare services when required. The provider worked with other healthcare professionals to help ensure people's needs were met. Where people needed help with drinks and meals, this was provided.

People were cared for by staff who were kind and compassionate. People were involved in decisions about their care and support needs. Staff respected people’s privacy and dignity.

People were supported in a way which was personal to them and people's individual needs and preferences were known to staff, who respected them. There were arrangements in place for people to raise concerns about the service.

We have made a recommendation about staff training.

We have made a recommendation about supporting people to make decisions where they lack capacity.

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 25 July 2018 and this is the first inspection.

Why we inspected

This was a planned inspection.

Enforcement

We have identified breaches in relation to monitoring risk, medicines, recruitment processes and the governance of the service.

You can see what action we have asked the provider to take at the end of the full report.

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.