About the service
Hidmat is a domiciliary care agency, providing personal care to 31 people at the time of the inspection.
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
Care records did not contain sufficient information and guidance to enable staff to support people in a safe way. Risk management was not always in place for falls, pressure area care, catheter care, diabetes management and the use of oxygen.
The provider did not always follow its recruitment policies and procedures to ensure staff were recruited safely.
It was unclear if staff had received adequate training for their roles. The training records were out of date and there were gaps in some staff training records.
There were no recent audit of medicines management and some staff competencies in medicines were out of date.
Some staff training in infection control and prevention was out of date
The service had sufficient numbers of staff, but there was a lack of supervision and spot checks on staff performance.
Governance arrangements did not provide assurance that the service was well-led. The provider had not ensured that their systems and processes to monitor the quality of care was effective. The provider had not ensured the service had a registered manager in place.
There was a lack of analysis of incidents and it was not clear that lessons were learned, and improvements were made when things went wrong.
Positive feed-back was received from people and their relatives about the service and its staff. Staff were positive about the service and the support from the management team.
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 21 July 2019) and there were multiple 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 enough improvement had not been made or sustained and the provider was still in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
We received concerns in relation to recruitment processes and incident management. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this report.
You can see what action we have asked the provider to take at the end of this full report.
During the inspection the manager took immediate steps to address our concerns and make immediate improvements.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hidmat Care Ltd on our website at www.cqc.org.uk.
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.
We have identified breaches in relation to poor risk assessment and a lack of quality monitoring of the service.
Please see the action we have told the provider to take at the end of this report.
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.
Since the last inspection we recognised that the provider had failed to ensure there is a registered manager in place at the service. This was a breach of regulation. Full information about CQC’s regulatory response to this is added to reports after any representations and appeals have been concluded.
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 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.