Archived: Family Care Agency

Updated 15 August 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection was completed by two inspectors.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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. At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection. Inspection activity started on 24 August 2022 and ended on 8 September 2022. We visited the location’s office on 24 and 26 August 2022.

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We spoke with one person who used the service and three relatives, to learn about their experiences of the service provided. We spoke with six staff members including the registered manager. We also received feedback from four health and social care professionals who knew the service.

We reviewed a selection of care records for six people including medicine administration records, care plans, risk assessments, daily notes and incident forms. We reviewed five staff files and records relating to training, recruitment, performance management and support.

We reviewed a selection of records relating to the management and quality monitoring of the service. These included complaint management, accident and incident monitoring, quality audits, meeting minutes and provider oversight. We also reviewed a selection of policies and procedures.

Updated 15 August 2023

About the service

Family Care Agency is a domiciliary home care service. The service provides personal care and support to people living in their own homes. At the time of our inspection there were 15 people using the service.

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

We found people were at risk of potential harm due to poor quality risk management and there was a lack of guidance and training available for staff in relation to people’s specific care needs. Medicine records were not always maintained. People and their relatives told us they felt safe, however, safeguarding systems were not always effective at protecting people from potential risk of harm. We received mixed feedback from health and social care professionals regarding the safety of the service.

There was a lack of effective systems and processes to ensure quality of care. Staff were not always aware of roles and responsibilities and the registered manager lacked knowledge in relation to safe medicine practices. Procedures were not in place to analyse care visit times to ensure people received care as planned. Feedback from people using the service and their relatives was mostly positive. However, this feedback indicated care was not being delivered as detailed within people’s care plans. The provider sought feedback from people using the service through customer surveys. Staff had opportunity to raise concerns during one to one supervision with the registered manager. The provider understood their legal responsibilities with regards to duty of candour and was open and transparent during the inspection process.

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; the policies and systems in the service supported this practice.

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 requires improvement (published 5 October 2019) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made in relation to previously identified concerns, however, new concerns were identified, and the provider remained in breach of regulations.

Why we inspected

We received concerns in relation to the management of medicines and potential neglect of people’s care needs. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to inadequate based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. 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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Family Care Agency on our website at www.cqc.org.uk.

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 monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment, safeguarding, governance oversight and staffing at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

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.