Archived: Good Companions (Manchester)

Updated 8 March 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 5 and 6 February 2019 and was announced. The provider was given 24 hours' notice because the location provides a domiciliary care service and we needed to be sure that someone would be available to facilitate the inspection. The inspection was carried out by one inspector and on the first day an inspection manager.

Due to the timeframe in which this inspection was completed, a Provider Information Return (PIR) was not requested to support us with our inspection planning. A PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. However, we reviewed information we already held in the form of previous inspection reports.

We contacted Trafford local authority commissioning team, to obtain their views about the quality of this service. Feedback received was limited, due to the service supporting two people.

During the inspection we visited two people using the service with their permission. We spoke with four staff members, including the registered manager, the director and two care staff. We reviewed records relating to the care people were receiving, including contemporaneous notes (daily records), two care plans and two people's medication administration records (MARs) for January and February 2019. Information and records that underpin the running of the domiciliary care service was limited, due to records not being available such as audits, policies and procedures and supervision records. We reviewed individual training profiles and one recently recruited staff personnel file/recruitment record.

Updated 8 March 2019

This inspection visit took place on 5 and 6 February 2019 and was announced, which meant we gave the provider 24 hours' notice of our visit.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. At the time of this inspection the service was supporting two people and was delivering 112 hours of personal care each week, with each visit undertaken by two care workers.

Good Companions (Manchester) is part of a franchise organisation, providing domiciliary care and support to people within their own homes. CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating.

We last inspected Good Companions (Manchester) in August 2018. At that inspection, we found multiple breaches of regulations, the service was rated Inadequate and placed in special measures. We also served two warning notices against the registered provider for Regulations 17 and 18. Shortly after this inspection the provider agreed to impose a voluntary embargo, which meant they would not take on new packages of care until CQC were satisfied the service had made the necessary improvements. This voluntary embargo remains in place.

At this inspection we identified five continuing breaches of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014. People were placed at risk because there was a lack of leadership, governance and managerial oversight of the service.

The service had a manager who had been registered with CQC since July 2016. 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.

The provider had continued to fail to ensure that robust governance systems were in place to monitor the quality and safety of care people received. Due to these poor systems, the provider could not be assured that people had received their medicines correctly.

The provider had not ensured there were enough care staff working for the service to cover the care visits required. This has resulted in the registered manager and provider consistently covering these visits which impacted on their ability to co-ordinate, structure and monitor the quality of care being given to people.

Not all staff had received the appropriate training or supervision before they performed certain tasks such as giving people their medicines which put people at risk of unsafe care.

Recruitment processes continued to be inadequate. Staff were being employed before all pre-employment checks were undertaken. This meant people were at risk of harm because staff recruited may not be suitable for the role.

We were not assured from discussions with staff, our observations and a review of care records that staff and the registered manager and provider fully understood their roles and responsibilities in relation to the Mental Capacity Act 2005.

Although we found staff were knowledgeable in safeguarding, training had still not been made available from the provider.

At the time of our inspection, no person was receiving end of life care. We noted that staff had not received training in this area, and care plans did not consider people’s preferred priorities.

The overall rating for this service is 'Inadequate' and the service therefore remains in 'Special measures'.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their 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.

You can see what action we told the provider to take at the back of the full version of the report.