Background to this inspection
Updated
12 November 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
One inspector visited the office location on 4 October 2021.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service did not have a manager registered with the Care Quality Commission. This means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided. The provider had recently recruited a new manager who had been in post for one month, however, they left during the inspection.
Notice of inspection
The inspection was unannounced.
Further inspection activity was completed via telephone and by email, which included speaking with staff and reviewing additional evidence and information sent to us. Inspection activity started on 4 October 2021 and ended on 15 October 2021.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We asked to speak to people who received a regulated activity or their relatives, about their experience of the care provided. No one was willing to speak to us as part of this inspection. We spoke with five members of staff including the manager, care coordinator, administrator and care workers. We reviewed a range of records. This included three people’s care records and two people’s medication records. We looked at two staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We contacted the nominated individual to seek further assurances regarding the stability of the service. The nominated individual is responsible for management of the service on behalf of the provider. The nominated individual did not respond.
Updated
12 November 2021
About the service
A New Angle Ltd (Scarborough) is a domiciliary care service providing care and support to people with a range of support needs living in their own homes. There were eleven people being supported at the time of our 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
The safe running of the service was directly impacted by a lack of financial resources/management. Operational issues such as late payment of staff wages and non-payment of office utilities had put people and staff at risk.
The manager left during the inspection and the provider had no oversight of the service. Staff, relatives and stakeholders had lost faith in the provider due to persistent concerns about operational issues. Many staff had left the service due to ongoing payment issues with the provider.
The provider had not always been open and honest. Notifications about ‘events that stop the service’ had not been submitted when required.
Quality assurance systems in place did not monitor the service fully and did not identify the shortfalls we found during the inspection.
People’s risks associated with health conditions were not risk assessed or care planned to support staff with action to take to support people. People were not protected from the risk of spread of infection such as COVID-19 as the service was not following up to date government guidance in relation to staff testing. The risk assessments and guidance to staff in relation to COVID-19 was also out of date and lacked detail.
We could not be sure that medicines were being safely administered as prescribed due to various systems failures such as gaps in recording, protocols missing and missing information. There was no records of accidents and incidents and no evidence of any lessons learnt.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 17 March 2018).
Why we inspected
We received concerns in relation to provider operational issues which resulted in a high turnover of staff. This included staff not being paid on time. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to inadequate. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this report. You can see what action we have asked the provider to take at the end of this full report.
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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to medicines, infection prevention and control, governance, financial position, keeping the statement of purpose for the location up to date and telling CQC when things have happened. Please see the action we have told the provider to take at the end of this report.
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 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.
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.