About the service Empathy Care24 Northampton is a domiciliary care agency providing personal care to people in their own homes. At the time of our inspection there were 86 people using the service.
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
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.
Right Care:
Risks to people were not always identified or managed safely. People's care plans and risk assessments did not always reflect people's current needs. We found missing information in people’s care records in relation to equipment, pressure care and medicine administration.
Staff did not always report incidents to the registered manager or relevant office staff. Trends and patterns were not always identified by the registered manager to improve safety across the service.
People were not always protected from the risks of infection. People and their relatives told us staff wore personal protective equipment (PPE) when being cared for however, we observed staff not to be wearing face masks when supporting a person in their home.
Staff had received training in how to report allegations of abuse. People and their relatives told us they felt safe. Staff were recruited safely.
Right Support:
Mental capacity assessments were not always completed for decisions relating to people’s care or treatment. We received mixed feedback from people and relatives if staff gained people’s consent before supporting them with their care needs. Staff demonstrated an awareness of the importance of choice and consent.
Staff had access to people’s care plans and risk assessments before providing care to people. Not all people’s care plan's and risk assessments provided information on people’s current care needs and risks. Where other professionals were involved in aspects of people’s health and care, this was not always recorded in people’s care plans.
Staff had received training in moving and handling, first aid, food hygiene and mental capacity. Staff had also received training on supporting people with a learning disability and autistic people.
People were provided with enough to eat and drink. Staff kept records on when people were provided with food and drink. Staff had received training in providing nutritional support to people.
Right Culture:
Systems in place to assess, monitor and improve the service were ineffective. The shortfalls found during the inspection had not been identified by the provider through quality monitoring processes.
We received mixed feedback from people and relatives in relation to communication with the registered manager and office staff. People’s feedback was gathered through care review meetings and spot check visits. People and their relatives also had the opportunity to provide written feedback via a questionnaire.
Staff meetings gave staff the opportunity to raise concerns and discuss improvements to people’s care.
The registered manager and nominated individual were guided to review the Right Support, Right Care, Right Culture guidance to ensure they fully understand the requirements should they support people with a learning disability or autism in the near future.
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 12 February 2022) and there were 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 the provider remained in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
At our last inspection we recommended that where people have the capacity to consent, their consent and agreement is clearly recorded. Improvements had not been made or sustained.
Why we inspected
We received concerns in relation to personal care support, catheter care and short care calls. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
We have found evidence that the provider needs to make improvements.
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 Empathy Care24 Northampton 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 monitor the service and will take further action if needed.
We have identified breaches in relation to risk management, consent to care and management oversight 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.
At the time of inspection, it appeared that we had not received statutory notifications for notifiable incidents. We are currently looking into this matter.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.