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Karva Care Services Limited Requires improvement

Reports


Inspection carried out on 15 July 2019

During a routine inspection

About the service

Karva Care Services Limited is a domiciliary care agency providing personal care to 10 people at the time of the inspection. 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 told us they felt safe and were supported by staff who understood the risks associated with their care. Care plans and risk assessments were not in place for all of people’s known risks. Where care needs had changed care plans and risk assessments had not always been updated to reflect people’s most current needs. This placed people at risk of receiving unsafe care. People were supported by staff who understood the appropriate action to take should they be concerned about people’s safety.

People received effective care. 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. However, the policies and systems in the service did not always support this practice. People were supported to receive appropriate healthcare in line with their specific needs. Staff had received training in line with people’s needs. Not all the people using the service required support with eating and drinking but where they did there was some guidance in people’s care plans.

People received support that was caring and kind. People and their relatives, where appropriate, were involved in their care. People had their dignity and privacy respected and their independence promoted.

People did not always receive care that was responsive to their needs. Whilst people and their relatives had been involved in developing their care plans and reviewing them as and when their needs changed, we found that care records had not been kept up to date. People were able to raise concerns and complaints and be assured these would be investigated.

The service was not consistently well-led. Governance systems to monitor the quality and safety of the service were either not in place or not robust. People were able to feedback their views of the service. The registered manager acted openly and responsively during the inspection ensuring they took immediate action to improve any areas of improvement we identified.

Rating at last inspection

The last rating for this service was Good (published 05 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified a breach in relation to a lack of robust systems to monitor the quality and safety of the service, Good Governance. The provider took action following the inspection to address the issues identified at the inspection. Please see the action we have told the provider to take at the end of this report.

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Inspection carried out on 16 November 2016

During a routine inspection

We undertook this announced inspection 16 and 17 November 2016. The provider had been given 48 hours’ notice of the visit. This was the first inspection of this service. Karva Care is registered to provide personal care to adults who live in their own homes in the community. At the time of the inspection they were providing personal care to 25 people who had various support needs including living with dementia and high levels of physical disability.

There was a registered manager in post. 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.

We found people received a service that was based on their personal needs and wishes. People's needs had been assessed before they started receiving care and people we spoke with told us they had been involved in developing their care plans. Changes in people's needs were not noted in their care records in a timely manner. Risks people might experience with their care and their environments had been identified and were managed well.

The service only supported a small number of people with their medicines. We found that people’s medicines were managed safely. We saw that people were supported to be as independent as possible to take their own medicines. Where support was required, all processes for recording and managing medicines safely were followed.

We found the service employed enough staff to meet the needs of the people being supported. People who used the service were happy with the numbers of staff that supported them and knew them well.

People were supported by staff who have been assessed as suitable to support them safely. We found that staff were trained and supported to undertake additional training as necessary. Staff knew how to recognise and respond to abuse correctly.

Staff told us they felt well supported and received regular supervision. Staff spoke highly of the management and support they received. People and staff knew how to make a complaint and felt confident that it would be dealt with well. People were encouraged to give their views about the quality of the care provided to help drive up standards. There were no formal systems in place to monitor and ensure that the service was effective and improving, and the registered manager had a limited understanding of the Mental Capacity Act.

Inspection carried out on 11 February 2015

During a routine inspection

This inspection took place on 11 February 2015. We gave the provider 24 hours’ notice to make sure that there would be someone in the office at the time of our visit.

Karva Care Services is a small domiciliary care agency which provides personal care to people in their own homes. At the time of our visit there were eight people using the service. Karva was providing a service to people who had been discharged from hospital and who needed support, initially for the for a six week period. Some people had continued to use the service after that period. The service has a registered manager.

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.

People using this service told us that they felt safe. There were good systems for making sure that staff reported any allegation or suspicion of poor practice and staff were aware of the possible signs and symptoms of abuse.

People told us that they were happy with the service provided. People told us that they were included in decisions about how their care was provided. People told us about how staff helped them to retain skills and to stay as independent as possible.

People told us that staff treated them with dignity and respect. Staff working in this service understood the needs of the people for whom they provided care. Staff were aware of people's needs arising from their medical conditions.

Staff were appropriately trained and skilled to provide care and support to people. The staff had completed relevant training to make sure that the care provided to people was safe and effective to meet their needs.

The Mental Capacity Act 2005 (MCA) states what must be done to ensure that the rights of people who may lack mental capacity to make decisions are protected, including when balancing autonomy and protection in relation to consent or refusal of care. The MCA Deprivation of Liberty Safeguards (DoLS) requires providers to submit applications to the Court of Protection for authority to deprive someone of their liberty. We did not find anyone being deprived of their liberty.

The registered manager encouraged feedback from people who used the service, their family members, advocates and professional visitors, which she used to make improvements to the service.

The registered manager assessed and monitored the quality of care consistently. In addition to regular observations and supervision of staff, the manager consulted people using the service to find out their views on the care provided.