Background to this inspection
Updated
3 December 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The service was inspected by one inspector and an expert 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.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes and flats.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service 24 hours' notice of the inspection. This was because the service was small, and people are often out and we wanted to be sure there would be people at home to speak with us.
What we did before the inspection
We reviewed information we held about the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with the registered manager and the nominated individual. The nominated individual (NI) is responsible for supervising the management of the regulated activity provided. We reviewed a range of records. This included four people's care records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were viewed. We spoke with two people and four relatives. We reviewed call monitoring data. We sent a staff questionnaire to all staff, and we received feedback from six staff members.
Updated
3 December 2022
About the service
New Dawn Healthcare is a domiciliary care agency. The service provides personal care and support to 14 people. Not everyone who used the service received personal care.
The Care Quality Commission can only inspect the service received by people who get support with personal care. This includes help with tasks related to personal hygiene and eating. Where people receive such support, we also consider any wider social care provided.
People's experience of using this service and what we found
People and their relatives told us staff had the necessary skills to carry out their roles. People were happy with the care they received.
Risks to people had not always been assessed and planned for. The provider’s risk assessment did not record how staff could reduce the risk of avoidable harm. The provider was not receiving referral forms or carrying out initial assessments and instead captured information in care plans and risk assessments. These however were not always accurate as they lacked important information about people. People’s nutritional and hydrational needs were not always been met. Medicines were not always administered safely.
We were not assured that people received the consistent level of care in accordance with their care plans.
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.
The provider did not have effective quality assurance systems in place to monitor the quality and safety of the care provided.
Staff had access to appropriate personal protective equipment (PPE) to help prevent the spread of infection. Recruitment procedures were robust. Staff understood how to report safeguarding concerns.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection and update
The previous rating for this service was good (report published on 8 February 2020). At this inspection the rating has changed to requires improvement
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement and Recommendations
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 safe care and treatment, person centred care, consent and good governance at this inspection. We have also made recommendation to ensure staff receive supervision and staff meetings in line with the providers policy. 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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.