Archived: We Care Homecare Ltd

Updated 11 November 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 9 September 2015 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in.

The inspection team consisted of two inspectors and two experts by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. Both experts by experience had personal experience of caring for a relative who used care services.

Before the inspection we spoke with the local authority safeguarding and commissioning teams concerning 12 safeguarding concerns which had been received since the last inspection on 11 March and 1 April 2015. We reviewed the providers action plans which had been sent informing us how and when the provider would meet our regulations. We reviewed three warning notices that had been served on the provider. We also reviewed previous inspection reports, safeguarding records and other information of concern received about the service. We reviewed notifications which had been sent to us by the service. A notification is information about important events which the provider is required to tell us about by law.

On the day of the inspection we spoke with 23 people who used the service and four relatives. We also spoke with five care staff, two office staff and the registered provider.

We reviewed a range of records about people’s care and how the service was managed. We looked at care plans for ten people which included specific records relating to people’s capacity, health, choices, medicines and risk assessments. We looked at daily reports of care, incident and safeguarding logs, complaints, service quality audits and minutes of meetings. We looked at the training plan for 43 members of staff and recruitment, supervision, appraisal and training records for four members of staff.

We asked the provider to send us information after the visit. We requested copies of their policies and procedures and training and supervision planners to be sent to us by Friday 11 September 2015. These were received by this date.

Updated 11 November 2015

This inspection took place on 9 September 2015. The inspection was announced.

We Care Homecare Ltd provide personal care services to people in their own homes. It covers a wide area in Portsmouth and surrounding districts, providing services to older people and younger adults. At the time of our inspection there were 143 people receiving care and support from the service. There were 43 care staff, seven office staff and a deputy manager.

At the time of our inspection We Care Homecare Ltd had been without a registered manager since October 2014. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are “registered persons”. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. When we visited the service the registered provider was managing the service.

At our last inspection on 11 March and 1 April 2015 we found the provider was in breach of eight of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider did not have effective processes to protect people from abuse and to investigate any allegation of abuse.

Staff who were recruited did not have the experience to meet people’s needs. Staff were not deployed effectively. Steps were not taken to reduce risks where recruitment checks were not complete or satisfactory. People received their medicines late because of missed or late calls therefore we could not be certain that people received their medicines safely and at the right times. Supervisions and spot checks were not completed for staff. The principles of the Mental Capacity Act were not applied. Planned care was not always provided, complaints were not always followed up or responded to and the provider failed to act on feedback to evaluate and improve the service.

As a result of these breaches three warning notices were served. The provider was also requested to send us an action plan and tell us how and when they would meet our regulations. At the inspection on 9 September 2015 we found that minor improvements had been made with the recruitment of staff and staff’s understanding of the Mental Capacity Act 2005 but the service had not reached the standards required by the regulations and had not met the warning notices.

At the last comprehensive inspection on 11 March and 1 April 2015 this provider was placed into special measures by CQC. This inspection found that there was not enough improvement to take the provider out of special measures. CQC is now considering the appropriate regulatory response to resolve the problems we found.

People and staff continued to raise concerns about medicines and records remained ambiguous.

People were not protected against the risk of avoidable harm because the provider failed to respond and investigate potential safeguarding concerns effectively. Improvements had been made with the induction training provided to new staff but there were still concerns about the experience of staff recruited and their effective deployment.

Staff received supervisions, appraisals and updated training; however the effectiveness of the training and feedback from spot checks did not always equip staff with the right skills.

People’s care worker preferences were not always met. People felt the office staff did not listen to them and were not kind and caring. People were not always receiving their care visits or not receiving planned care at the correct times which suited people’s preferences. Complaints and concerns were not always responded to or followed up.

People said the service was not well led. Staff did not always feel supported.

The provider sought feedback from people regarding their service, however they had not sought feedback from staff and could not demonstrate they had responded to or dealt with some of the concerns still present in the service. The provider had not conspicuously displayed their rating of the outcome of their previous inspection.

Improvements had been made with staff’s understanding of the Mental Capacity Act 2005; however we could not be certain of the effectiveness of the provider’s processes in assessing capacity. We made a recommendation to the provider to follow guidance for the Mental Capacity Act 2005. The provider followed the correct recruitment and selection processes. People felt care workers were kind and caring, supported them to be as independent as possible and listened to their views. People’s privacy and dignity was maintained when they were receiving personal care.

We found a number of continued and new breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 20104. We also found the provider was in breach of the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of this report.