Our Care Ltd

Our Care Ltd is a domiciliary care service providing personal care. The service provides support to older people, some of whom are living with dementia or have mental health needs. The service also supports younger adults, people with sensory impairment and people with physical disabilities. At the time of our inspection there were 12 people using the service.

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

Although improvements to governance systems had been made, further action was needed to ensure they were fully embedded and provided a comprehensive view of the service. People, relatives, and staff spoke positively about the management of the service. Staff worked in partnership with other professionals to meet people’s needs.

We have made a recommendation about governance processes.

People felt safe when receiving care. Improvements had been made to medicines management and the management of people’s risks. Records reflected how people’s risks should be managed and staff were aware of how to support people safely. Learning had taken place since the last inspection and staff followed infection control guidance to protect people from the risk of cross infection.

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 requires improvement (published 12 January 2023). The service remains rated requires improvement. This service has been rated requires improvement for the last 3 consecutive inspections.

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 and the provider was no longer in breach of regulations.

Why we inspected

We carried out an announced comprehensive inspection of this service on 27 October 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

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 remain requires improvement. This is based on the findings at this inspection.

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

Enforcement and Recommendations

We have made a recommendation about governance processes in the well-led section 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 work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Our Care Ltd is a domiciliary care service that provides personal care to people living in Wolverhampton and surrounding areas. 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 our inspection visit, the service was providing personal care support to approximately 18 people.

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

People did not always receive their medicines in a safe way. People did not always have care plans and risk assessments in place to give clear guidance to staff to meet their needs.

People were not always supported in a safe way to drink where they required thickener in their fluids. People did not always have access to healthcare professionals in a timely way when there were changes to their needs.

Quality assurance tools were not in place to identify concerns we found at this inspection around medicines and people's care records.

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 care plans did not always contain comprehensive information about their preferences. We have made a recommendation about the review of how these are reflected in people's care records.

People did not always have information about their care needs recorded in their care plans. We have made a recommendation about the review of people's care records to ensure they contain information about their communication needs.

People were supported by staff they described as 'kind' and 'caring'. People were supported to remain independent and their privacy and dignity was promoted. People felt able to raise concerns and these were dealt with in a timely way.

People were supported to receive care at times they preferred by regular staff. People did not feel rushed and told us staff knew them well. People were supported by safely recruited staff who received regular training. Staff supported people in line with infection control guidance.

People felt able to give their feedback on the service and knew who the provider was.

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 requires improvement (published April 2020).

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 the provider remained in breach of regulations.

Why we inspected

The inspection was prompted in part due to concerns received about people’s care and support. A decision was made for us to inspect and examine those risks. The overall rating for the service has remained requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well-led sections of this full report.

The provider worked with us during our inspection to reduce the significant concerns we found around people’s support with medicines. This reduced the imminent risk to people during our inspection.

Enforcement and Recommendations

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 people’s safe care and treatment and the oversight at the service.

Follow up

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.

Our Care Ltd is a domiciliary care service that provides personal care to people living in

Wolverhampton and surrounding areas. 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 our inspection visit, the service was providing person care support to approximately 26 people, some of whom were living with dementia.

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

The provider had not ensured that staff followed safe systems and recorded the support they had given to people with their medicines. Risk management plans were not always detailed or reviewed consistently to ensure staff had the guidance they needed to support people safely.

The provider’s systems had not ensured that people always received a reliable, consistent service. Care calls were not always planned to allow travelling time, which meant staff frequently ran late and people sometimes felt their care was rushed, which compromised their dignity.

There was a lack of oversight of the service. The service had grown rapidly in a short space of time and the provider was not effectively monitoring the quality and safety of the service. People and relatives knew how to complain but did not always feel confident their concerns would be listened to or acted on. The provider had systems to gather feedback on how the service could be improved but could not demonstrate that these were being effectively operated and people’s views acted on.

People had good relationships with the staff they saw on a regular basis. Staff supported people to access health care services when they needed to and ensured people had choice when they supported them with meals.

Staff were recruited safely and had up to date training and ongoing support to fulfil their role.

The provider and staff understood their responsibilities to gain people’s consent before providing care. People had 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 Good (published 20 October 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to the safe management of medicines, the effective management of complaints and governance of the service.

Full information about CQC’s regulatory response to the more serious concerns found during the inspections is added to reports after any representations and appeals have been concluded.

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.

The registered provider, Our Care Limited, is a domiciliary care agency which provides support and care to adults living with physical disabilities or mental health difficulties. The majority of people receiving a service lived alone, whilst others lived with other family members. At the time of our inspection, the agency was providing personal care to 18 people.

The service had a 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.

People were protected from harm when receiving personal care because the provider conducted risk assessments which identified specific risks for each person and gave guidance to care workers about how they could assist people in a way which promoted their independence and choice. We found further improvement was needed to ensure that risks associated with a change in care packages for people were fully documented.

People were supported with their medication by care workers who were trained and assessed as competent to give medicines safely and as prescribed. People believed care workers had the skills and training to undertake the care being provided. We found the provider provided care workers with training and professional development and had a system in place to ensure training was up to date.

People told us they felt safe and comfortable with the regular care workers employed to meet their needs. The provider employed care workers who were able to adjust their work hours to try to ensure there were sufficient care workers available who could safely meet people's needs at the times agreed.

The provider had a clear system for employing new staff and ensured pre-employment checks were conducted prior to staff starting work to confirm workers could be safely employed.

People were protected from abuse because the provider ensured care workers knew their responsibilities to protect people from the risk of abuse and that they received training to assist them.

The provider ensured care workers received training on mental capacity and we found care workers demonstrated a working understanding of the principals of the Mental Capacity Act (2005) and obtained people’s consent before providing personal care.

People were able to make choices about the way their care was provided. Care plans focussed on the individual care and support needs of the person, and copies were stored securely at the main office and where appropriate at people’s homes.

People received assistance to access health professionals when needed and the provider ensured they had regular contact with health care professionals to ensure care plans reflected people’s current needs.

People and their relatives told us most care workers were caring and they enjoyed the time they spent with their regular care workers.

The views of people and their relatives about the service were listened to and appropriate actions were taken to improve the service people received.

People and their relatives knew what to do if they had any concerns about their care, and the provider responded positively to any issues or concerns raised.

Care workers took responsibility for the quality of their work and were encouraged to suggest ways to improve the service.

The provider had systems to assess, monitor and improve the quality of the service and obtained feedback on the service provided.