Background to this inspection
Updated
29 July 2020
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 Care Act 2014.
Inspection team
The inspection was conducted by two inspectors and an Expert by Experience. An Expert by Experience is 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 homes.
The service had a manager registered with CQC, who is also the nominated individual for the provider organisation. A nominated individual is a person who is responsible for supervising the management of the service on behalf of the provider. This means they alone are legally responsible for how the service is run and for the quality and safety of the care provided. In this report, we will refer to them as the registered person. During the inspection the registered person was not available. The day to day running of the service was delegated to a general manager and a manager whose aim was to become the registered manager. We spoke with both of these members of the management team during the inspection, however the manager left the service prior to the inspection being completed.
Notice of inspection
We gave a short period notice of the inspection. This was because we needed to be sure that the registered person or member of the management team would be in the office to support the inspection. Inspection activity started on 8 January 2020 and ended on 17 January 2020. We visited the office location on 8 January 2020.
What we did before the inspection
Before the inspection we reviewed the information we had received about the service, including previous inspection reports and action plans. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with three people who used the service and nine relatives about their experience of the care provided. We spoke with seven members of staff including the manager, general manager, care coordinator and care workers. One care worker provided us with feedback via email.
We reviewed a range of records. This included six people’s care records and five people's medication records. We looked at three staff files in relation to recruitment. A variety of records relating to the management of the service, including quality assurance systems were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at people’s daily records and a further recruitment file.
Updated
29 July 2020
About the service
Fairhaven Healthcare Limited is a domiciliary care agency. It provides personal care to people living in the community. At the time of inspection Fairhaven Healthcare Limited was providing personal care to 31 to people 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.
People’s experience of using this service and what we found
People did not always receive a service that ensured their safety.
Medicines were not managed safely. There was a lack of oversight of medicine administration. There was a lack of information about some people's medicines such as what they took and what the medicines were for. Medicine administration records were not always complete.
Risks to people's health and wellbeing had not always been assessed, monitored or mitigated effectively. People were at risk of harm because staff did not always have the information they needed to support people safely. The provider had not established an effective system to ensure people were protected from the risk of abuse.
Staff were not recruited safely. This meant people were potentially at risk of staff being employed
to work with them who were not suitable. There were not enough staff to ensure people received support in a timely way that met their needs and preferences.
The service was not well led.
The registered person did not have enough oversight of the service to ensure that it was being managed safely and that quality was maintained. Quality assurance processes had not identified concerns or driven sufficient improvement relating to service quality. Records were not always complete. People were not always given the opportunity to feedback about their care. The lack of robust quality assurance meant people were at risk of receiving poor quality care.
Following the inspection, the registered person acknowledged the concerns that we identified during the inspection and told us of their plans to make improvements regarding care records, medicine records, staffing, recruitment, training and quality assurance systems.
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 (report published 9 October 2019). There were multiple breaches of regulation. We issued a warning notice requiring the provider to make improvements regarding the safe care and treatment of people.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Fairhaven Healthcare Ltd on our website at www.cqc.org.uk.
At this inspection, we identified five breaches of regulation in relation to safe care and treatment, safeguarding people from abuse, the employment of fit and proper persons, staffing and good governance.
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.
Why we inspected
We undertook this focused inspection to confirm the provider now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those Key Questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to inadequate. 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 Fairhaven Healthcare Ltd on our website at www.cqc.org.uk
Follow up
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.