Background to this inspection
Updated
23 June 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 two inspectors and an Expert by Experience. 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 homes.
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 we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 02 November 2022 and ended on 03 January 2023. We visited the location’s office on 02 November 2022.
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 who work with the service.
The provider was not asked to complete 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.
During the inspection
During the inspection we spoke with the registered manager and two operations managers. We also spoke with 9 staff members
We spoke with 18 service users and 6 relatives. We reviewed 19 service users’ care plans and records. We also reviewed a range of other records including 5 staffing recruitment files.
Updated
23 June 2023
About the service
Sagecare Lincoln is a domiciliary care service that provides personal care and support for people in their own homes. The service can provide care for adults of all ages and covered Lincoln and surrounding areas. At the start of our inspection there were 181 people using the service, but this was changeable throughout the inspection period.
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
Systems and processes were not always effective in sustaining improvement at the service. Quality assurance systems did not always identify and act on issues and concerns.
The provider monitored care call data which identified continued staffing deployment concerns. There was no action plan in place to address these issues and this directly impacted on people’s care.
Medicines were not always managed safely. We found concerns with how medicines information was recorded.
Risks to people were not always managed effectively. Relevant information was not always recorded by staff and lessons were not always learnt following incidents.
Staff recruitment was not always safe, as work history was not always recorded; however, staff did have other up to date safety checks in place.
People told us some staff did not always wear appropriate person protective equipment (PPE). The provider had taken some action to address staff not wearing PPE.
Staff did not always feel engaged by the provider. Some people and relatives felt the service communicated with them effectively, but others did not.
Some staff were not always aware of provider whistleblowing procedures. Safeguarding systems were in place to protect people and staff knew what signs to looks out for to protect people from abuse. People and relatives told us they felt the service was safe.
The service worked closely with other agencies to support people.
People were supported to have maximum choice and control of their lives and staff supported did them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
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 December 2021) and there were breaches of regulation. At this inspection we found the provider remained in breach of regulations and remains rated requires improvement. The service has been rated requires improvement for the last three consecutive inspections.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection. We also undertook this inspection to check whether the Warning Notice we previously served in relation to Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met.
The overall rating for the service has remained requires improvement based on the findings of this inspection. You can see what action we have asked the provider to take at the end of this full report. The provider has taken some action to mitigate the risks outlined in this report.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Sagecare (Lincoln) on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to medicines, risk management and 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 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 work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.