Archived: Precious Passionate Care Ltd

Precious Passionate Care Ltd is a domiciliary care agency providing personal care 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. At the time of our inspection there were 64 people receiving personal care.

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

People were not always safe. People, relatives and staff said the service had deteriorated in recent months and communication was poor. People’s care needs were not always met as staff were not deployed effectively. People and their relatives told us care calls were often late or missed and staff did not stay the full duration of the call. People said sometimes staff were sent who did not know how to meet their needs.

People were at risk of harm as the provider had not identified, assessed or mitigated risks. Safeguarding incidents were not always identified and acted upon appropriately or promptly. Medicines were not managed safely.

Care records did not reflect people’s needs and were not always clear about the care to be provided on each call. People and their relatives said they were unable to access their care records.

There was a lack of effective leadership and an ineffective governance structure which meant the service was not appropriately monitored at manager or provider level. Quality assurance systems were not implemented.

People and their relatives said the staff were nice, friendly and chatty. Staff were recruited safely and safe infection control procedures were followed.

The nominated individual told us action would be taken to address the concerns we identified at this inspection.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location did not care or support 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.

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 21 November 2018).

Why we inspected

We received concerns in relation to the management of the service, staffing and meeting people’s care needs. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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 inadequate based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the Safe 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.

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

Enforcement

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 safe care and treatment, staffing, safeguarding and good governance 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.

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.

This inspection took place on 31 October and 1 and 2 November 2018 and was announced. The provider was given short notice of our intention to inspect the service. This is in line with our current methodology for inspecting domiciliary care agencies to make sure the registered manager would be available.

At our previous inspection in September 2017 we rated the service as ‘Requires Improvement’. There were no regulatory breaches. This inspection was to check improvements had been made and to review the ratings.

A registered manager was in post who was also the Company Director. 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 and relatives told us the service was reliable as staff arrived on time and provided the care and support needed without rushing. People received care from staff who were familiar to them as they had been introduced and had an opportunity to get to know the person and their care needs before providing support. People and relatives had confidence in the staff and felt safe with the care staff who visited.

Staff were recruited safely and received the induction, training and support they needed to carry out their roles. Staff understood how to recognise signs of abuse and the action to take if they found or suspected this was happening. Safeguarding incidents were recorded and reported appropriately.

People received person-centred care. People and relatives told us they were involved in decisions about their care and developing their care plans. Care records reflected people’s needs and preferences and showed the support needed from staff on each call. Risks were assessed and plans were in place to manage them. People were supported with their nutritional needs and in accessing healthcare services. People received their medicines when they needed them, although the guidance for staff around when to give ‘as required’ medicines needed to improve.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People and relatives praised the staff who they said were kind and caring, treated them with respect and maintained their dignity. People and relatives knew how to raise any concerns and there was a complaints procedure in place.

People, relatives and staff felt the service was well-managed and spoke highly of the registered manager. The management team had recently increased to provide additional support to the registered manager. Quality assurance systems were in place to monitor the service and ensure ongoing improvements.

Precious Passionate Care Ltd is registered to provide personal care to people in their own home. At the time of the inspection 28 people were using the service. 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 we spoke with and their relatives said the service was safe. They were very complimentary about the care they received and the care workers and management team who supported them. They had regular contact with the registered manager who was described as wanting ‘to get it right’ and ‘so good’. People felt the service was person centred and were supported to make decisions about their care. Several people told us the provider went the extra mile. People were invited to the provider’s anniversary party to celebrate their first year. This was funded by the provider and held at a community centre with a tribute singer, catering and a champagne toast. Transport was provided.

Care plans contained good information about tasks to complete at each visit and how staff should deliver care. Risks to people who used the service were also assessed. The provider was introducing assessment tools to assist in the assessment of risk. Systems were in place to make sure people received their medicines as prescribed.

There were enough staff to meet people’s needs and visits were well planned so they met people’s preferences and the same care workers visited which ensured continuity of care. Recruitment checks were carried out but these were not always fully completed before staff were employed. The registered manager agreed to make sure there was a clearer record on file of when employment commenced and the date staff started working directly with people who used a service.

Staff told us the management team and colleagues provided very good support on a day to day basis. Staff received training and supervision to help make sure they understood their role and responsibilities although the supervision matrix only covered the last session so it was difficult to establish all staff had received the required number of sessions over a longer period of time. A development manager had commenced the week of the inspection and was going to be overseeing training and supervision. The provider agreed to develop the induction training programme because it did not include all modules in the care certificate which is an identified set of standards that workers adhere to in their daily working life.

The provider had some effective systems in place to monitor the service and were continuing to develop these. We identified two safeguarding incidents reported to the local safeguarding team should have been sent as notifications to the Care Quality Commission. Once we brought this to the attention of the registered manager they submitted the notifications retrospectively. We have made a recommendation about reporting incidents. Accident records were not always fully completed and lessons learned were not clearly recorded.

People who used the service, relatives and staff said they would feel comfortable raising any concerns or complaints and had opportunities to share their experiences to help improve the service.