Archived: Carradice Care Ltd

This service is a domiciliary care agency. It provides personal care to people living in their houses and flats in the community. It provides a service to older adults and younger disabled adults. At the time of the inspection 33 people were using the service.

The agency had a registered manager who was present on the day of our inspection visit. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At our previous inspection in August 2016, the provider was in breach of regulation 16, receiving and acting on complaints and regulation 17, Good governance. We found that the provider did not investigate or respond to complaints. The governance was ineffective to assess, monitor and to drive improvements.

At this inspection we found that the provider had not taken sufficient action to comply with these regulations and people continued to be at risk of not receiving a safe and effective service. We found a further breach of regulation 18, Staffing. The registered provider did not ensure that all staff had the necessary skills and competence to assist people safely with their care.

The management of people’s medicines was not safe to ensure they received their medicines as directed by the prescriber. People were placed at risk of harm because staff did not always have access to risk assessments that provided accurate information. People were not always protected from the risk of potential abuse. Staff’s failure to wear their uniform and carry identification at all times, placed people at risk of allowing unauthorised persons into their home. People were at risk of avoidable infections because staff did not always wash their hands or use personal, protective equipment. Accidents were not managed effectively to reduce the risk of it happening again. Insufficient staffing levels meant calls were frequently late.

Staff did not have access to relevant training to ensure they had the skills to care and support people safely. Staff were not always supported in their role to ensure they provided an effective service. Staff’s lack of understanding of the Mental Capacity Act 2005 placed people at risk of their human rights not being respected.

People could not be confident their right to privacy and dignity would be respected by all staff. Staff were not always attentive to people’s needs and they did not always have access to relevant information about people’s care and support requirements. People’s complaints were not always listened to, taken seriously or acted on. During the assessment of people’s needs equality, diversity and human rights were not explored. People were involved in the assessment of their care needs.

Where needed people were provided with support to eat and drink sufficient amounts. People who used the service did not require support to access relevant healthcare services.

At the time of the inspection there was no one who used the service receiving end of life care.

Carradice Care is registered to provide personal care to people living in their own homes. There was a registered manager in place who is also the registered provider. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. At the time of our inspection 30 people received care and support services.

Where people’s medicines were administered by staff records did not accurately record when medicines had been administered. The provider had procedures in place to check that people received their medicines but these were not robust enough to ensure action was taken when issues were identified.

People told us that they felt more care staff were needed as staff often arrived late to provide support without prior notification. Staff told us more care staff were required to cover periods of leave and sickness.

We found risks to people’s health and safety had been assessed and suitable plans of care put in place. We checked staff records and saw that staff had been recruited following appropriate checks.

People told us that staff provided a choice when supporting them with the preparation of meals. However people said the support was inconsistent as some staff provided poor quality meals and required guidance on how to prepare food.

The care people received was inconsistent and dependant on which member of staff supported them. People felt some staff did not treat them, their home and belongings with dignity and respect. People said some staff were caring and kind and supported them to maintain their independence.

Staff sought people’s consent before providing care and supported people to access healthcare professionals when required. Complaints were not logged, investigated or responded to and the provider had not learned from them to improve people’s care experiences and reduce the likelihood of events happening again. People and staff were not confident that if they raised any concerns action would be taken.

People told us they were not listened to or involved in their care and in making decisions about their care, therefore the service could not always be sure it provided care in line with people preferences.

The provider checks and audits needed improving as they did not assess, monitor and drive improvement in the quality and safety of the services provided. Staff told us they could approach the provider for advice and guidance but they would like more support through supervisions and team meetings.

The provider had identified some improvements needed to be made and had a new staff structure to take this forward including the appointment of a new manager and two new care supervisors. This was planned to enable them to concentrate on their provider role and take a lead on checks and audits to ensure the quality of care was monitored.

You can see what actions we told the provider to take at the back of the full version of this report.