Niche Care Rotherham

Updated 17 March 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.

Inspection team

This inspection was conducted by two inspectors and an Expert by Experience; a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses. The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service short notice of the inspection. This was because we needed to be sure the inspection could be inspected safely during the ongoing COVID-19 pandemic.

What we did before the inspection

Before the inspection, we reviewed all the information we held about the service including information about important events which the service is required to tell us about by law. We requested feedback from other stakeholders. These included two local authorities who commissioned services from the provider, and the local safeguarding team. We also looked at concerns people using the service or their representatives had raised with CQC prior to the inspection.

We used all of this information to plan our inspection.

During the inspection

Inspection activity commenced on 1 February and finished on 9 February. We visited the service on 5 February 2021.

We spoke with eight people using the service and five people’s relatives. We also gathered information from eight members of staff including care workers and the registered manager.

We looked at care records for 11 people using the service We looked at training and recruitment records for staff. We also reviewed various policies and procedures and the quality assurance and monitoring systems of the service. As part of the inspection, we referred information of concern to the local authority’s local safeguarding team and contracts team.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 17 March 2021

About the service

Niche Care is a domiciliary care agency providing personal care to adults living in their own homes. 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 the time of the inspection, the service was supporting around 300 people.

People’s experience of using this service and what we found

We found concerns relating to governance within the service. Although there were comprehensive systems in place to enable managers to monitor the service, we saw many examples of poor quality and at times unsafe care. Management records showed there was an awareness of late calls, short calls and missed calls, but people told us these were still happening; care records reflected this.

Managers had failed to take appropriate action when concerns were identified. They had not reported certain key incidents to the Care Quality Commission, which is a legal requirement. They had also failed to report a breach of confidential personal information to the Information Commissioner’s Office. The registered manager addressed this after we brought it to their attention.

We have made a recommendation that the registered person has robust oversight of complaints and concerns, so that any allegations of abuse are identified and reported in accordance with the law.

We were not assured people were being cared for safely. Care visits did not always take place at the agreed time or for the agreed duration. This meant people were at risk of harm where, for example, their medication was not administered at the correct time, or they had to wait a long time before being taken to the toilet or given a drink.

People using the service and their relatives gave us a mixed picture about their experience of Niche Care. Some praised the service, with one person telling us: “The care package is reviewed regularly and there is an annual review where [we] have the opportunity to discuss. The mobile app is really effective where we can monitor regularly. Everything is listed including medicines, visits done, timings etc.” Another person said: “[my relative] gets on well with her regular carers. They are brilliant.” However, some people commented far more negatively, raising concerns about late and missed calls and staff not having the knowledge they required. We reported one matter to the local authority safeguarding team.

Staff also gave us a mixed picture of Niche Care. Some were very positive about their employer, saying they felt well supported and would recommend them to anyone seeking care, but others were not of this view, and described the company as disorganised, citing examples of late rotas and last minute changes, alongside poor levels of support.

Recruitment was undertaken safely, with appropriate background checks before staff started work, and staff received training in relevant areas relating to care and safety.

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

Rating at last inspection

The last rating for this service was Good (published March 2019)

Why we inspected

The inspection was prompted due to concerns received about how the provider was ensuring care was delivered safely in a way that met people’s needs, and about the provider’s governance arrangements. A decision was made for us to inspect and examine those risks. As this was a focussed inspection, we reviewed the key questions of safe and well led only. Ratings from previous comprehensive inspections for other key questions were used in calculating the overall rating at this inspection. The overall rating for the service is now requires improvement.

We have found evidence that the provider needs to make improvement. Please see the Safe and Well Led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

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.