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Caterham Domiciliary Care Agency Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 30 October 2020

About the service:

Caterham Domiciliary Care Agency provides personal care and support to people living in their own homes. This includes three people in supported living accommodation owned by the provider. Services are provided to older people, those with a mental health diagnosis, physical and learning disabilities and sensory impairment. 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. At this inspection we focused on the people that lived in the property owned by the provider who were in receipt of the regulated activity ‘personal care’.

People’s experience of using this service:

People were not being protected from the risk of abuse. There had been instances of abuse from staff where the provider and registered manager had doubts about their suitability to work in the supported living home. Risk assessments were not always detailed around the needs of people with a mental illness or those that had a behaviour that challenged. Incident forms were not being completed in relation to incidents of behaviours. There were other risk assessments present that gave guidance to staff for example on moving and handling and people’s skin integrity.

The recruitment of staff was not robust and training and supervision for staff was not always effective in ensuring good care. The registered manager was not following good practice in relation to infection control particularly around COVID 19. Consent was not always being obtained from people where necessary and where people lacked capacity the principles of Mental Capacity Act 2005 were not being followed.

Pre-admission assessments did not always take place and care plans did not always contain accurate information about people. The leadership at the service was not robust and appropriate quality assurance was not taking place.

Rating at last inspection:

The last rating for this service was requires improvement (published 8 April 2019) and there were multiple breaches of regulation. At that inspection we identified breaches in relation to the lack of choices around the care provision, the lack of detailed care planning, the quality and safety of people’s care, training and supervision of staff, the principles of the Mental Capacity Act not being followed, and the lack of quality assurance undertaken at the service.

Why we inspected:

We undertook a targeted inspection due to concerns we received relating to incidents of alleged abuse and to review the progress made by the service to become compliant with the multiple breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This report only covers findings in relation to care which people received, safe care and treatment, safeguarding people from abuse, consent to care, staffing and quality assurance. The overall rating for the service has not changed following this targeted inspection and remains Requires Improvement.

CQC have introduced targeted inspections to follow up on a Warning Notice or other specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

Enforcement:

We have identified continued breaches in relation to the safety of care provided and the quality assurance of the service.

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 until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner. We will continue

Inspection areas

Safe

Requires improvement

Updated 30 October 2020

Inspected but not rated.

Details are in our Safe findings below.

Effective

Requires improvement

Updated 30 October 2020

Inspected but not rated.

Details are in our Effective findings below.

Caring

Requires improvement

Updated 30 October 2020

Responsive

Requires improvement

Updated 30 October 2020

Well-led

Requires improvement

Updated 30 October 2020

Inspected but not rated.

Details are in our Well-Led findings below.