11 December 2019
During a routine inspection
Caring Hands Homecare (Fylde & Wyre) Limited is a domiciliary care service providing personal care to people in their own homes. At the time of our inspection the service was supporting 12 people with 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.
People’s experience of using this service and what we found
At this inspection we found failures in the provider's quality and assurance systems. Records relating to care and the management of the service were either incomplete, inaccurate and/or not kept up to date. This compromised the quality and safety of the service provided.
People were not safeguarded from the risk of abuse because the provider could not show staff had been trained or informed how to recognise the potential signs of abuse. There was no evidence incidents of potential abuse had been referred to the local authority safeguarding team or investigated adequately by the provider.
People did not always have risks to their personal safety identified. When they had been identified, control measures were not in place or were contradictory, therefore risks were not mitigated. People's medicines were not always managed safely. Not all staff who administered medicines had received training or guidance as to how to do this safely.
Staff were not safely recruited. Recruitment files seen were incomplete and there were some missing. We could not be assured who was currently employed by the provider or what checks had been made before employing them.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests. The policies and systems in the service were not followed to support this practice.
We found not all staff had received training to complete their role. Staff had not received adequate support in their role. We saw evidence health professionals were contacted when required.
We saw some caring staff and positive interactions during our inspection. However, failures in systems resulted in people not always receiving a caring service. The way care provision was being managed was not respectful of people.
The service did not promote a positive person-centred culture which promoted good outcomes for people. Audits and checks at the service were not completed to identify areas of improvement. The provider had failed to notify appropriate agencies, including CQC of safeguarding concerns. There was no evidence people had been consulted about the care they received.
The service was not well led. There was a registered manager who had not worked at the service for some time. The managers employed by the provider to run the service had all subsequently left. On the day of inspection, the provider was being supported by temporary staff who did not have access to the full information they required to assist the provider. The provider had begun discussions with an alternative provider to transition care packages and de-register.
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 17 May 2019).
Why we inspected
The inspection was prompted in part due to concerns received about staff members being employed without barring and disclosure checks (DBS). The commission also received intelligence suggesting staff members were working for the service without training and that care visits were not being completed. A decision was made for us to inspect and examine those risks.
We planned to complete a focussed inspection to look at the risks. However, we have found evidence to substantiate the concerns. Therefore, as per our guidance we completed a full comprehensive inspection. We found concerns in relation to staff employment checks, staff training, management of risks, medicines, leadership and care records. Please see the safe, effective, responsive, caring and well led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement
We have identified breaches in relation to safe care and treatment, safeguarding service users from abuse and improper treatment, good governance, staffing, need for consent and fit and proper persons employed at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
The overall rating for this service is ‘Inadequate’. Since our inspection the provider has submitted the form to de-register this service. This means that they will no longer be registered to carry out a regulated activity. Therefore, the service does not need to be placed into special measures.