Background to this inspection
Updated
12 April 2023
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 Health and Social Care Act 2008.
Inspection team
The inspection was carried out by 1 inspector and an Expert by Experience who made calls to people using the service and their relatives. 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 houses and flats.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 14 March 2023 and ended on 17 March 2023. We visited the location’s office on 16 March 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority service improvement and safeguarding teams. The provider completed a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 13 people who used the service and 2 relatives about their experience of the care provided. We spoke with and received feedback from 9 members of staff including the nominated individual, registered manager, deputy manager, care team manager and care workers. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included 3 people's care records and medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
12 April 2023
About the service
Candlelight Homecare Services Wimborne Area Office is a domiciliary care agency providing person care and support to people in their own homes and flats. The service provides support to older people some of whom are living with dementia. At the time of our inspection there were 32 people receiving personal care.
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 the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group. This was considered throughout the inspection.
People’s experience of using this service and what we found
Improvements were needed as governance processes and oversight were either not in place or operating effectively within the service. Systems had not been established to monitor, safety, quality, and ensure the service continually sought to improve. The provider had not identified the shortfalls found within this inspection but had been responsive since the inspection to address the improvements needed.
Risks to people’s safety and wellbeing had been identified. However, guidance was not always in place to ensure staff worked to reduce risks and in safe ways. We have made a recommendation about the assessment and management of risk.
People received their medicines as prescribed. However, oversight of medicines was not robust. Medicines care plans were not in place. Guidance had not been created to ensure medicines taken as required were offered consistently. We have made a recommendation about medicines and safe practices.
Accidents and incidents were reported, recorded, and reviewed. However, learning from incidents was not always shared within the service and providers locations. The service actively sought feedback on the service it provided, this was not shared with people, this was an area for development.
Recruitment procedures were in place and robust, ensuring staff had the necessary values and skills to support people who needed care services. People and their relatives told us they were satisfied with the service they received. There were enough staff to meet the needs of people, the service worked continually to provide regular staff to promote continuity of care.
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. Infection prevention and control procedures were robust, and staff had enough supplies of personal protective equipment (PPE).
Staff felt appreciated and told us they were proud to work for Candlelight Homecare Services Wimborne Area Office. We received positive feedback about the management team and the registered manager was approachable and contactable.
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 28 September 2018).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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 changed from good to requires improvement based on the findings of this inspection.
Enforcement and Recommendations
We have identified a breach of regulation in relation to the management and oversight of the service. We have made recommendations about risk and medicines management at this inspection. Please see the action we have told the provider to take at the end of this report.
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.