Background to this inspection
Updated
19 October 2023
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
This inspection was carried out by 2 inspectors 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 houses 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 not a registered manager in post.
Notice of inspection
We gave a short period notice of the inspection. This was because it is a small service and we needed to be sure that the provider would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority partners. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.
During the inspection
We spoke with 1 person who used the service and 8 relatives or friends about their experience of the care provided. We also spoke with 9 members of staff including, the nominated individual, the branch manager, and 7 care assistants. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included 5 people's care records and multiple medication records. We looked at 7 staff files in relation to recruitment. We also looked at a variety of records relating to the management of the service, including policies and procedures.
Updated
19 October 2023
About the service
iCare Solutions Wakefield Ltd is a domiciliary care agency which provides personal care to people living in their own homes. At the time of our inspection there were 11 people using the service, this included older people and people living with physical disabilities.
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
Shortfalls identified at the previous 3 inspections had not been addressed by the provider, which led to ongoing and repeated breaches.
Risks to people’s health and safety, including infection risks, continued because of a lack of thorough assessments of their needs. Medicines were still not being managed safely and there was no assurance people received their medicines when they needed them. Safe recruitment procedures were not followed to ensure staff working with vulnerable people had necessary background checks.
At the last inspection we made a recommendation regarding the provider’s process for call monitoring. There had been some attempt to establish a system, however this was not effective and lacked assurance people’s visits were reliably made.
A new manager had been appointed at the last inspection. However, they were unable to fulfil their management role or dedicate time to address the concerns about the service, as they had largely been deployed in people’s care delivery. Some attempts had been made by the manager to devise quality assurance systems, such as spot checks of staff practice, but there were no robust audits of quality and safety. The manager told us surveys had been completed to gain feedback from people and relatives, but was unable to demonstrate how or when these had been carried out. The provider had taken no action to understand the risks in the service, or address the concerns from previous inspections.
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 inadequate (published 26 April 2023) and there were breaches of regulation.
At this inspection we found the provider remained in breach of regulations.
Why we inspected
We carried out an announced inspection of this service on 3 and 7 August 2023. Continued breaches of legal requirements were found in relation to safe care and treatment, good governance and fit and proper persons employed.
We undertook this focused inspection to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained inadequate. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for iCare Solutions Wakefield Limited on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified continued breaches in relation to safe care and treatment, good governance and fit and proper persons employed 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.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review.
If the provider has not made enough improvement 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.