Archived: High Care Plus Ltd

High Care Plus Ltd is a domiciliary care service providing personal care to people in their own homes. 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. At the time of our inspection the service supported 23 people with personal care needs.

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

There was a lack of managerial and provider oversight of the service which meant risks to people’s welfare and safety were not being robustly managed. Systems in place had not ensured people received their care calls. This had led to people’s care calls being missed or provided later than planned. The provider did not have robust systems in place to monitor staff practice, knowledge of people and understanding of their needs.

Risks to people’s safety were not always assessed and acted upon. Medicines processes were not safely managed and records did not evidence that people were receiving their medicines in line with their prescriptions. Robust recruitment processes were not in place and the provider had not monitored staff training and support. Staff had not completed training appropriate to people’s specific needs such as dementia, epilepsy and pressure care.

Systems were not in place to monitor and report concerns such as safeguarding, complaints and accidents and incidents. This meant the local authority were not aware of potential risks and appropriate action was not always taken to minimise the risk of concern happening again. The provider had failed to notify CQC of significant concerns in line with their statutory responsibilities.

People’s needs were not always fully assessed. Not all those receiving care had a care plan in place to guide staff on how their care should be provided. People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

We received positive feedback from people regarding the staff who supported them. They told us they were caring and respected their privacy.

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 26 November 2018 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about people’s care calls being missed and staff not taking action where there was no response on arrival at a person’s care call. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well-led sections of this full report. The provider has taken action to minimise risks to people’s safety and are working with the local authority to monitor the service.

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

Enforcement

We have identified breaches in relation to the safe recruitment, training and deployment of staff, the monitoring of risks to people safety, the failure to report safeguarding concerns and to record and monitor accidents and incidents, complaints and missed calls. Person-centred care was not embedded into practice, assessments were not robustly completed and care plans were not completed for all those receiving a service. There was a lack of management oversight of the service and quality assurance systems had not been implemented.

Full information about CQC’s regulatory response to these concerns can be found 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.

The overall rating for this service is ‘Inadequate’ and the service in ‘special measures’. 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 rating, 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.