24 October 2022
During a routine inspection
All-Care ltd- Oxford Branch is a domiciliary care service providing the regulated activity of personal care. The service provides support to people living in their own homes. At the time of our inspection there were 65 people using the service.
The service also supports people who are discharged from hospital and require support with rehabilitation for an initial proposed period of six weeks. People receiving this rehabilitation care are referred to by the service as ‘reablement care clients’. At the time of inspection 18 people out of 56 who were receiving a regulated activity were in receipt of a reablement care package.
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
People were not always protected from the risk of harm. Care plans did not always contain information specific to people's needs or contain information on how to support people to manage any conditions they had. Staff were not always provided with detailed guidance to follow when supporting people with complex needs.
Medicines were not always managed safely as records did not contain information about risk or management of medicines. The provider had an auditing system which included auditing medicines; however, shortfalls found during inspection were not always picked up by these audits.
Staff we spoke with understood their responsibilities to report concerns. There was not a sufficient number of staff available to keep people safe and meet their needs, we heard from people using the service that often staff were late, that the allocated 7am-11am window was not meeting people’s needs and there were occasions where morning calls were missed.
When incidents or accidents occurred, it was not always clear these were investigated, and if any lessons were learnt. There were systems in place to monitor the safety and quality of the service. However, there were shortfalls in ensuring all documentation was accurate and up to date across people’s records.
People and their families gave mixed feedback about being involved in the planning of their care. Some people's records contained conflicting information leading to uncertainty about what people's up to date care and support needs were. These risks were mitigated as staff had good knowledge of the people they were supporting.
People's dignity and privacy were respected, people and relatives gave good feedback about staff being kind, caring and respectful.
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
This service was registered with us on 10 November 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.
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 person centred care (Regulation 9), safe care and treatment (Regulation 12), good governance (Regulation 17) and staffing (Regulation 18).
You can see what action we have asked the provider to take at the end of this full report.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.