Archived: iCare Solutions Wakefield Limited

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.

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 2 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, were still not being adequately assessed, monitored or managed. Medicines were still not being managed safely and we could not be assured people received their medicines as prescribed. The provider continued not to practice safe recruitment when employing new staff members, including when recruiting to management positions.

We have made a recommendation regarding the provider’s process for call monitoring.

Leaders were still unable to demonstrate they had the necessary skills and expertise to deliver a safe service. Quality assurance systems were no longer in place, as audits of quality and safety were not taking place and had not taken place since our last inspection. This meant opportunities to drive improvements in the service were being missed. The provider had also failed to establish effective systems for gathering views from people, their relatives and staff.

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 20 December 2022) 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 09 and 11 November 2022. 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 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 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.

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.

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 14 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

Risks to people’s safety were not adequately assessed or mitigated and risks associated with infection control were not effectively managed. Safe recruitment practices were not followed, and medicines were not always managed safely.

Staff did not receive a thorough induction. Staff received e-learning training, but not all staff had received the training they required to carry out their role. The assessment process was not effective as people’s needs, and the support they required from staff, was not always clear.

Where there were systems and processes in place to monitor and improve the quality of the service, these were ineffective as they had not identified issues found at this inspection. The provider did not have a clear understanding of their regulatory responsibilities and failed to take enough action in response to the previous inspection, which led to ongoing breaches.

People and relatives told us the service was safe and they noted an improvement in staffing levels. Staff received regular spot checks and supervisions; they also spoke positively about the support they received. People and relatives were largely happy with the care they received and, along with staff, had noticed some improvements in the quality of the service in recent months.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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 6 June 2022). 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.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 23 March 2022. Breaches of legal requirements were found in relation to safe care and treatment, good governance, staffing and fit and proper persons employed. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective 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.

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

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, 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 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.

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 within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will continue to take action in line with our enforcement procedures. 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.

iCare Solutions Wakefield Limited is a domiciliary care agency which provides personal care to people living in their own homes. At the time of our inspection there were 43 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

Risks to people were not always assessed, monitored or managed effectively. Systems for supporting people with their medicines as prescribed were not effective. Accidents and incidents were not consistently recorded or analysed, which meant staff could not learn from these events. Infection control measures were not always in place.

Effective recruitment procedures were not in place to make sure staff were of suitable character and background to work with people using the service. Staff were not provided with relevant training and ongoing support to make sure they had the right skills and knowledge to support people.

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.

Care records lacked detail and contained limited information about people’s life histories, wishes and preferences. People’s care plans and risk assessments were not reviewed on a regular basis.

The provider's policies and procedures were not specific to the service. The provider had failed to establish effective systems and processes to monitor and improve the quality and safety of the service. The registered manager did not have a clear understanding of their regulatory responsibilities.

People and their relatives felt the service was safe. People and their relatives mostly spoke positively of the care and support they received from staff. People said staff were caring and treated them with respect. People and their relatives were asked for feedback about the service.

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 9 September 2021 and this is the first inspection.

Why we inspected

The inspection was prompted in part by concerns received about staff recruitment, staff training and managerial oversight of the service. A decision was made for us to inspect and examine those risks.

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 safe care and treatment, good governance, staffing and fit and proper persons employed.

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 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.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. 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.