25 April 2023
During a routine inspection
JM Kamau Ltd T/A ProField is a domiciliary care agency providing personal care to people in their own homes. At the time of our inspection there were 32 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, assessed or action taken to mitigate risks to people. People's care plans and risk assessments did not always reflect people's current needs. The provider had not ensured all staff administering medicines were competent to do so.
Staff had received training on how to report allegations of abuse. People and their relatives told us they felt safe. Staff were recruited safely.
People and their relatives told us staff were kind, caring and respected their privacy and dignity.
People were protected from the risks of infection. Staff told us they wore personal protective equipment (PPE) to reduce the risk of spreading infections.
Right Support:
Mental capacity assessments were not always completed for decisions relating to people's care or treatment. People’s care plans required further development to include information on people’s health conditions, preferences, likes/dislikes and information on who was important to them.
Staff had not received additional training to meet people's needs. Staff had not received training in diabetes, catheter care, pressure care and interacting with autistic people and people with a learning disability.
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.
Initial assessments took place to ensure that the service could meet people’s needs prior to admission into the service. Staff worked with other healthcare professionals to ensure people’s needs were met in a timely manner.
Right Culture:
Systems were not in place to assess, monitor and improve the service. Shortfalls found during the inspection had not been identified by the provider through quality monitoring processes.
People's feedback was gathered through care review meetings and spot check visits. People and their relatives had the opportunity to provide feedback via a questionnaire.
The registered manager was 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
This service was registered with us on 8 June 2021 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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.
Enforcement and Recommendations
We have identified breaches in relation to assessing risks, medicines, assessing people’s capacity to consent and management oversight at this inspection.
Please see the action we have told the provider to take at the end of this report.
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 continue to monitor information we receive about the service, which will help inform when we next inspect.