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Archived: ICare Solutions Manchester Limited Requires improvement

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Reports


Inspection carried out on 12 December 2016

During a routine inspection

We inspected ICare Solutions Manchester on 12, 16 and 20 December 2016. The first day of inspection was unannounced. The second day was spent visiting people in their homes who received a service and the third was spent back in the office providing feedback to management.

ICare Solutions is a domiciliary care service providing personal care and support to people living in their own homes. The service also works closely with healthcare commissioning teams in supporting people who have a range of healthcare needs. The hours of support vary depending on the assessed needs of people.

At the time of the inspection the service was supporting 75 people within the local community of Manchester and Stockport. We last inspected the service on 1 May 2014 when we found the provider was non-compliant in Regulation 12 of the Health and Social Care Act 2008.

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.

People told us they received safe care, which was reliable and consistent. The service had sufficient staff to meet people’s needs, and people were given the time they needed to ensure their care needs were met.

We saw that people were protected from avoidable harm. During the inspection we checked to see how the service protected vulnerable people against abuse and if staff knew what to do if they suspected abuse. There was an up to date safeguarding vulnerable adult’s policy in place. Risks to people were assessed and risk management plans were in place. We found that the staff we spoke with had a good knowledge of the principles of safeguarding.

Risks posed to people were identified during the assessment process. Care plans we looked at contained information in relation to risks that had been identified for individuals, for example when mobilising or having medicines. Environmental risks had also been identified and documented for staff.

Staff were trained to administer medicines. The registered manager was in the process of implementing a more thorough Medication Administration Record (MAR) chart for more accurate recording of medicines. The management team acknowledged that the medicines management system could be more robust and agreed to re-visit their policy, ensure this was aligned to best practice and implement any changes they needed to make the system safer.

The service was not working to the principles of the Mental Capacity Act, 2005 and staff did not receive any formal training on MCA. The service was not assessing and documenting, where necessary, people’s ability to consent to care.

The service had robust recruitment processes which included the completion of pre-employment checks prior to a new member of staff working at the service. This helped to ensure that staff members employed to support people were suitable and fit to do so. People who used the service could be confident that they were protected from staff that were known to be unsuitable to work with vulnerable people. Staff knew their roles and responsibilities and were knowledgeable about the risks of abuse and reporting procedures.

We saw evidence of the induction process and there was on going training provided for caring roles and responsibilities.

People were supported with a range of services which enabled them to continue to live in their own homes safely. People we spoke with who used the service and their relatives told us they had been involved in the assessment and planning of the care and support provided and that the service responded to changes in people’s needs.

The care records contained information about the support people required. We saw documented evidence of people’s likes, dislikes and prefere

Inspection carried out on 2 and 4 March 2015

During a routine inspection

This inspection was carried out on the 2 and 4 of March 2015 and the first day was unannounced. This means we did not give the provider prior knowledge of our inspection.

I Care Solutions Manchester Ltd is a small domiciliary care agency, which is registered to provide personal care to people in their own homes. The agency provides support for adults with a range of needs.

We last inspected I Care Solutions Manchester Ltd on the 5 July 2014 and during that inspection we identified breaches in five regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. We found peoples’ needs were not always assessed to ensure the appropriate care could be provided and the agency did not have suitable arrangements in place to ensure staff received appropriate training that enabled them to deliver safe and effective care. In addition we found the proper recruitment checks had not been followed to ensure unsuitable people were not employed by the agency and there were no systems in place to identify, assess and manage risks relating to the health, safety and welfare of people who used the service. Following the inspection carried out in July 2014, I Care Solutions Manchester Ltd provided us with an action plan detailing how improvements would be made. During this inspection we checked to see these had been completed.

The agency had a registered manager who had been registered with the Care Quality Commission (CQC) since June 2014. 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 were told by the registered manager they had returned to the agency on a full time basis in December 2014 following a period of extended leave. As required by regulation, the provider informed us of their leave.

During the inspection we found some improvements had been made. We saw recruitment checks were carried out to ensure suitable people were employed by the agency and training was provided to enable staff to deliver safe and effective care.

We found people were involved in assessments of their needs and care planning and relatives and people who used the service told us the staff were caring.

Staff were able to describe the procedures in place to report concerns if they were concerned someone was at risk of harm and abuse and people told us they felt safe when receiving care and support from staff.

However, we identified shortfalls in the arrangements for medicines. We also found shortfalls in the audit systems in place for medicines. You can see what action we told the provider to take at the back of the full version of the report.

Inspection carried out on 10 September 2014

During an inspection in response to concerns

We carried out this inspection in response to concerns raised regarding the effectiveness of the service.

An inspector visited this service on 10 September to carry out an inspection. We were also accompanied by a registration assessor for part of the inspection. Prior to our visit we looked at all the information we hold on this service to help us to plan and focus on our five questions;

Is the service caring?

Is the service responsive?

Is the service safe?

Is the service effective?

Is the service well led?

During this inspection we spoke with five relatives, seven care staff, the director and the acting manager of I Care Solutions Limited. The registered manager was not available on the day of our visit and we were informed by the director an acting manager was in post. We were also told the acting manager was currently receiving a handover from the registered manager. As part of this inspection we also visited three people in their own homes. Below is a summary of what we found.

Is the service caring?

The people we spoke with were happy with the care and support provided by I Care Solutions Manchester Limited. Comments included; "Staff treat me and my home with respect.�, and �I�m happy. I would tell them if I wasn�t happy.� We spoke with five relatives who also told us they found the staff to be caring. Comments we received included; �Staff are very good.�, and �The carer is excellent.�

Is the service responsive?

We were told by the acting manager people were encouraged to give feedback through telephone calls and at care meetings. We were also told questionnaires and surveys were not currently offered to people who used the agency but these would be introduced. However we concluded improvements were required to enable the agency to effectively monitor the quality of the service provided and introduce improvements if required.

Is the service safe?

We saw some systems were in place to ensure people were safe. We saw there was a safeguarding policy in place however this did not contain contact numbers for appropriate authorities. We spoke with seven staff and from our conversations it was clear not all staff knew who to report safeguarding concerns to. It is important staff know how and who to report concerns to as this minimises the risk of harm and abuse. We considered improvements were required to ensure allegations of abuse were responded to appropriately.

We also found appropriate recruitment checks to ensure the suitability of staff employed by the agency had not always been carried out. In one staff file we saw no evidence to show a Disclosure and Barring Check (DBS) check was in place or had been completed prior to the person starting work. In addition two staff we spoke with informed us they had not been formally interviewed prior to starting work with the agency and DBS checks had not been provided to the agency or received prior to the staff delivering care to people who used the service. We concluded improvements were required as sufficient recruitment checks help ensure unsuitable people are not employed to work with vulnerable people.

Is the service effective?

We saw no evidence in two care records that some people�s health needs had been assessed or care had been planned to meet their needs. The manager told us that they would review the care provided and update the care records to reflect people�s current needs. We considered improvements were required to ensure people received effective care.

Is the service well led?

The service had a manager in place who has been registered with the Care Quality Commission since June 2014. At this inspection the registered manager was not present. The CQC had been informed by the director of the company that the registered manager was leaving and an acting manager was currently in place.

We asked the acting manager and the director what audits were in place to identify, assess and manage risks relating to the health, safety and welfare of people who used the service. For example audits of timekeeping, medication and care records. We were told there were currently no audits carried out. We asked to see any previously completed audits and were told these had not been completed. We considered improvements were required to ensure risks to people who use the service were promptly identified and action taken to minimise risk.