Archived: Smart Care Plus Limited

Updated 25 October 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 11 April 2016 and 12 April 2016 and was unannounced.

The inspection was conducted by two inspectors. We carried out this inspection to check whether the provider had met the requirements of the warning notices which we had issued to them on 11 February 2016. The warning notices were issued in respect of Regulation 19 (Fit and Proper Persons employed) and 17 (Good Governance) of the Health and Social Care Act 2008 and associated regulations 2014. This was because we had concerns about staff recruitment and how the provider/manager ensured staff were of good character. We also had concerns about how the service was being managed and the providers/managers ability to assess, monitor and improve the quality and safety of services provided to people.

Prior to the inspection we had received concerning information from other organisations including the local authorities, the home office (Immigration) and the police. The organisations had raised concerns in respect of the validity and identity of staff working for the service. We had attended several meetings with these various professionals over the weeks leading up to our inspection. We had also received concerns raised by a whistle blower who was concerned about poor staff recruitment and staff working for the service using false names.

We looked at seven staff records including three staff members whom we had had concerns about at our previous inspection. Four staff records were pertaining to other staff employed by the provider. We looked at the staff rota for the week beginning 11 April 2016 and we spoke with one health care support worker over the telephone. We also spoke with the marketing manager over the telephone and attempted to speak with two other staff members who should have been on duty.

We spoke with four people who used the service over the telephone on the first day of the inspection to check if they had received their care. They told us that they had not had their visits for that morning. The Local Authority took people’s care files to ensure that provision was made for their care and welfare.

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Updated 25 October 2016

We carried out this inspection on 11 and 12 April 2016. The inspection was unannounced and carried out by two inspectors. We needed to check whether the provider had met the requirements of the warning notices which we had issued to them on 11 February 2016. The warning notices were issued in respect of Regulation 19 (Fit and Proper Persons employed) and 17 (Good Governance) of the Health and Social Care Act 2008 and associated regulations 2014. This was because we had concerns about staff recruitment and how the provider ensured staff were of good character. We also had concerns about how the service was being managed and how the provider assessed, monitored and improved the quality and safety of services provided to people. On this inspection we found that the provider had not made the necessary improvements and that the service was now more unsafe for people than at our previous inspection. As a result of this we have serious concerns about the service and the provider and we are continuing with our enforcement pathway in relation to this service.

The service was a domiciliary care provider and provided care and support to people in their own homes. At the time of our inspection the service was providing support to about 20 people although the provider was unsure of the exact number.

The provider was also the Registered 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.

This was a follow-up inspection looking at the areas of 'Safe' and 'Well-Led' and in relation to the breaches highlighted above.

Prior to the inspection we had received concerns from a Whistleblower that a staff member was working for the service under a false name. We had also received similar concerns before our last inspection on 16 December 2015. The Whistleblower also raised concerns that the managers of the service were unapproachable and that staff worked long hours for little pay.

Over the weeks leading up to the inspection we had been gathering information from other professional bodies about the service. This included information from various Local Authorities who provided funds for people to receive care and support from the service. We had also liaised with the police and Home office Immigration department. This was because these departments had an interest in and concerns about the service. Prior to this inspection we had attended several 'safeguarding meetings' where all the relevant professionals met to discuss their concerns and share information about the service. We were made aware that all relevant professionals had on-going concerns about this service. The Immigration department were very concerned that some staff members were working for the service and were not legally entitled to work in the country. The police had set the start time of the first day of the inspection at 6am and had wanted all parties to start at this time due to the sensitive nature of their investigations.

We looked at staff files and found that people who used the service were not safe. This was because processes and systems were not followed to ensure that staff were recruited safely. Suitable references were not obtained because the identity and validity of referees was in question. The provider had not checked to see if staff members’ names were included on the Disclosure and Barring System (DBS) list. This meant the provider could not be sure that staff were suitable to work with people in their own homes. The identity of some staff was also in question as the Immigration department knew that some staff were working for the service under false identification. Following this inspection the police looked through all the staff files and found more irregularities and discrepancies with staff recruitment.

People who used the service did not receive their calls on 11 April 2016. This had a major impact on people’s safety and welfare as they did not receive their care. There was no one in the office to manage the service in the absence of the provider to ensure that people received safe and effective care.

We found that the service was not well-led. This was because the provider had not made the necessary improvements to assess, monitor and improve the quality and safety of services provided. In respect of the three staff members employed with positive DBS checks in place including serious criminal convictions/cautions, the provider had done nothing to mitigate the risks of these staff members supporting people in their own homes. The risk had, in fact, increased, as the two remaining employees (one staff member had left), were often working together as a pair visiting people's homes. Plus the provider had increased their status to 'supervisors', meaning they would be supervising other staff. We gave the provider opportunity to find the evidence and information we required and they told us they had this but then were unable to produce it. The honesty and integrity of the provider was also brought into question by the police as it was highlighted where the provider had been untruthful about a staff member working for them.

You can see what action we told the provider to take at the back of the full version of the report.