Falcon Carers

Falcon Carers is a domiciliary care agency providing personal care to 37 people at the time of our inspection. The service largely provides support to people living in the Trafford borough of Greater Manchester.

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

There had been significant changes made at the service since our last inspection and the quality and safety of care people received was much improved.

People were supported by staff who knew their risks well and took actions to safeguard them from harm and abuse. There were enough staff at the service to meet people’s needs. Staff supported people to prompt and administer medications in a safe way and staff took the necessary precautions to mitigate the risk of the spread of infection.

Staff were recruited safely, and staff received training to enable them to support people effectively. Records had been updated to reflect people’s needs and wishes. People had access to healthcare as required. 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.

People’s feedback reflected an improved quality of care and people told us they were supported by staff who were kind and who promoted dignity and independence.

There was a complaints policy now in place and people knew how to make a complaint and raise concerns.

The electronic care record system was now fully operational, and this enabled the provider and the care coordinators to have a greater oversight of the service. Regular governance checks had now been put in place.

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

Rating at last inspection and update

The last rating for this service was inadequate (published 29 April 2022) and there were breaches of regulations.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since 15 October 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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

Follow up

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

Falcon Carers is a domiciliary care agency providing personal care to 44 people at the time of our inspection. The service provides support to people living in the Trafford borough of Greater Manchester. The registered office was in Stafford.

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

Risks were not assessed and managed in a safe way. Risk assessments were not always completed to support staff to keep people safe. Medicines were not managed safely. The systems in place to ensure people received their medicines safely were not robust and when errors had been identified, these had not been addressed. Staff were not always recruited safely, and we could not be assured staff had been effectively trained.

The provider had failed to report a safeguarding incident to the relevant authorities. Lessons had not been learned; the provider was unable to evidence sufficient improvement since the last inspection.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

The provider had a significant lack of oversight of the service. Records were not readily accessible, and the provider had little knowledge about their own systems.

People’s feedback had improved since the last inspection and staff told us they felt better supported in their role.

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

Rating at last inspection and update

The last rating for this service was inadequate (published 13 October 2021) 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. A condition was imposed on the provider's registration to restrict any further packages of care being commissioned with Falcon Carers. At this inspection we found the provider remained in breach of regulations.

Why we inspected.

This inspection was carried out to follow up on action we told the provider to take at the last inspection. We have found evidence that the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full report.

The provider had taken immediate actions to mitigate any urgent risk.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Falcon Carers 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 regulation 11 (need for consent), regulation 12 (safe care and treatment), regulation 13 (safeguarding service users from abuse and improper treatment), regulation 17 (good governance) and regulation 18 (staffing) at this inspection.

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

The overall rating for this service is ‘Inadequate’ and the service remains 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.

Falcon Carers is a domiciliary care agency providing personal care to 79 people at the time of the inspection. Most people supported lived in the Trafford area of Manchester. The registered office was in Stafford. 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 did not feel safe when being supported by the service. Risks to people were not always assessed and managed and staff were not always well trained to respond to people’s risks.

Medicines were not safely managed. Medicines records were poor, and issues had not been identified by the provider, despite them checking the medicines records.

People did not feel staff were competent and the provider could not be sure all staff had the correct training to deliver effective care. Safe recruitment practices had not always been followed.

People were not always supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

People’s privacy and dignity was not always respected. People felt staff rushed them. People told us about a language barrier that made communication with staff difficult and people could not always make their needs known. This meant people did not receive personalised care and their communication needs were not met.

The provider, who was also the manager had little oversight of the service. Records were disorganised which meant there was a delay in accessing some documents and records. People’s complaints were not dealt with appropriately, so people had lost confidence in sharing their concerns or feedback with the service. People did not feel involved in their care and support.

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 30 April 2019).

Why we inspected

We undertook a focused inspection of safe and well-led to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about poor moving and handling practices from staff which resulted in a person falling and injuring themselves. The decision was made for us to inspect and examine those risks.

We commenced telephone calls to people and relatives and found there were other concerns, so we widened the scope of the inspection to become a comprehensive inspection which included all key questions.

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.

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

The provider took action to mitigate some of the most serious risks we found including those in relation to medicines practices and staff training.

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 dignity, safe care, governance, handling of complaints, staff training and recruitment and notification of incidents at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Special Measures

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.

People’s experience of using this service:

People were protected from the risk of harm and abuse by staff that had received training and felt confident to raise any concerns they had. There was an up-to-date safeguarding and whistleblowing policy in place for staff to refer to.

Recruitment procedures were safe and sufficient staff were employed to meet the needs of the people supported. Staff had all completed an induction at the start of their employment and training for their roles. Staff told us they were fully supported through supervision and regular management contact.

People’s needs were assessed before they were supported by the service and this information was used to create person centred care plans and risk assessments. Risks to people were clearly identified and guidance was in place to reduce risk. Staff had access to clear information about people’s likes, dislikes and preferred routines. Care plans and risk assessments were regularly reviewed to remain up-to-date.

Medication procedures were safe. Medication was managed in accordance with best practice guidelines by trained and competent staff. Medication administration records (MARS) were fully completed and audits regularly undertaken.

An infection control policy and procedure was in place to minimise the risk of infection being spread. Staff had completed training and had access to personal protective equipment (PPE).

The registered provider complied with the principles of the Mental Capacity Act 2005. Staff had received training and understood and respected people’s right to make their own decisions.

People and their relatives told us they received support on time and from staff that stayed the full time. People told us the staff were polite and courteous, kind and caring.

The registered provider had a complaints procedure in place that people and their relatives were familiar with and felt confident to follow. They said the registered manager listened and was responsive to any concerns they had.

Rating at last inspection: Good (Report published April 2016)

Why we inspected: This was a planned inspection based on the rating of the last inspection.

Follow up: We will continue to monitor all intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

Falcon Carers provided personal care to people in their own homes. At the time of the inspection one person was using the service.

There was no requirement for a registered manager. The registered provider managed the service. For the purpose of this report we will refer to them as 'the 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 were protected from abuse as staff knew what constituted abuse and who to report it to if they suspected it had taken place.

There were sufficient staff to keep people safe and to support people to follow their hobbies and interests.

Risks to people were minimised to encourage and promote people's independence. Staff were clear how to support people to maintain their safety when they put themselves at risk.

People's medicines were managed safely by trained staff.

Staff were supported to fulfil their role effectively and were offered applicable training.

The Mental Capacity Act 2005 (MCA) is designed to protect people who cannot make decisions for themselves or lack the mental capacity to do so. The manager followed the principles of the MCA by ensuring that people consented to their care or were supported by representatives to make decisions in their best interests.

People were encouraged to eat and drink a healthy diet and their choices were respected.

People were supported to access a range of health care services. When people became unwell staff responded and sought the appropriate support.

Staff demonstrated a positive value base and treated people with dignity and respect.

Care was personalised and met people's individual needs and preferences. The manager had a complaints procedure and people knew how to use it.

The provider had systems in place to monitor the quality of the service.