Archived: Panashe Home Care Services Limited

Panashe Home Care Services Limited is a domiciliary care agency providing personal care to people living in their own homes. The service provides support to people living with physical health needs and conditions such as dementia. 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. The service also provides support to a very small number of people living with learning disabilities. At the time of our inspection there were approximately 58 people using the service.

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

People were not always safe. Some people were supported by staff who did not always provide care in line with safe and best practice. Some staff were not always caring and their behaviour towards people meant we were not assured people were always safeguarded from harm and the risk of abuse.

There were not enough staff to provide care that people required. Staff were scheduled to provide unrealistic hours of care which meant we were not always assured people received the care and support they needed.

The provider did not have clear oversight of the service. Systems and processes to monitor the quality of care, identify risk and make improvements to the service were not effective.

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 good (published 19 September 2019).

Why we inspected

We received concerns in relation to overseas staff allegedly working excessive hours and how staff provided care calls to people. 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 Panashe Home Care Services Limited on our website at www.cqc.org.uk.

Enforcement and Recommendations

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 people not being safe from the risk of harm and abuse, people not receiving safe care and treatment, insufficient staffing, unsafe recruitment practices and how the service is led at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.

Special Measures:

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.

Panashe is a domiciliary care agency. At the time of the inspection they were providing personal care to 22 older people or people with learning disabilities living their own homes.

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

People felt safe and were protected from abuse and avoidable harm. Staff knew when and how to report concerns. Systems and processes were in place to identify and manage risk. Action was taken when things went wrong to reduce the risk of reoccurrence.

People were asked if they had any problems or concerned and staff knew how to recognise when people were worried or distressed.

There were enough staff with the right skills and experience to meet people’s needs. People’s medicines were managed in a safe way. Staff supported people to keep their homes’ clean and tidy. They had access to personal protective equipment such as gloves and aprons and followed infection prevention and control policies to reduce the risk of infection.

People had their needs and choices assessed before they began using the service. Care and support was delivered in line with evidence based best practice guidance. Staff received the training and support they required to meet people’s needs. They had access to ongoing training and opportunities for professional development.

People were supported to eat and drink enough and staff promoted a healthy balanced diet. Staff recognized changes in people’s health and supported them to access the healthcare services they required.

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.

People received kind and compassionate care and support. They were supported by staff who knew them well and had developed positive relationships. Staff understood how to meet people’s needs and how to provide comfort and reassurance. People were involved in making decisions about their care and support. People had their privacy and dignity protected.

Care and support was person centred and was delivered in the way people preferred and met their individual needs. Staff understood people’s needs with regards to the protected characteristics of the Equality Act 2010. People were supported to follow their chosen religion and staff understood and respected people’s cultural needs.

Information was available to people in accessible formats and staff communicated with people effectively. People and relatives knew how to make a complaint and said they would feel confident doing so. Complaints were investigated and used as an opportunity to learn and improve.

People’s advanced care wishes were explored and recorded. Staff had received training about end of life care.

People, relatives and staff had confidence in the manager and felt supported. They told us the registered manager was accessible and approachable. Checks were carried out to ensure staff were following policies and procedures and people were safe. Action plans were developed when shortfalls were found and this contributed to continual learning and improvement.

People, their relatives and staff were asked for their feedback and this was used to develop the service and ensure it was meeting people’s needs and preferences. The registered manager and staff worked closely with healthcare professionals and other agencies such as the local authority to make sure people received joined up care and support.

Rating at last inspection

The last rating for this service was Good (published 13 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to review information we receive about the service until the next scheduled inspection. If we receive any information of concern, we may inspect sooner than scheduled. For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Panashe Home Care Services Limited is a domiciliary care service providing personal care and support to people living in their own homes. The office is based in the city of Leicester and the service currently provides care and support to people living in Leicester and Leicestershire. At the time of our inspection there were five people using the service. People’s packages of care varied dependent upon their needs. The provider employed four care staff.

This was our first inspection of the service since they registered with us on September 2016.

A registered manager was in post. 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 told us they felt safe with the staff providing the care. People were protected from harm and risks by staff who were trained, able to recognise signs of abuse and knew who to report concerns to.

People’s care needs were assessed and measures were in place to manage risks. People were involved in the development of their care plans which provided staff with clear guidance on how to support people safely whilst promoting their independence.

People were supported to take their medicines safely. Staff supported people, where required, with their meals and drinks. Records showed people were supported to access healthcare services when required.

The provider’s recruitment procedures ensured that staff were suitable to provide care and support to people living in their own homes. People’s needs were met by sufficient numbers of staff required in line with their assessed needs.

Staff were supported and received training on a range of subjects which equipped them with the skills and knowledge they needed to ensure people’s care needs were met. Staff had regular contact with the registered manager who worked alongside them in order to support them and meet people's care needs.

The registered manager and staff had an understanding of the key principles of the Mental Capacity Act 2005. Staff sought people’s consent before providing care and support and respected their wishes in how they wanted to be supported.

People and relatives spoke positively about the food that staff prepared. Staff worked with other health and social professionals to ensure that people received the health care they needed.

People told us they made decisions about how they wanted their care to be provided. Staff were knowledgeable about how people wished to be supported and their preferences which were consistent with their care plans. Staff maintained people's privacy and dignity whilst supporting them to remain as independent as possible.

Care plans were personalised and provided staff with clear guidance to enable staff to provide care that respected people’s individual preferences. Whilst people’s care needs were regularly reviewed the registered manager assured us they would pro-actively involve the person and their relative to ensure care plan were accurate.

People and relatives we spoke with were complimentary about staff’s attitude and approach and had developed positive relationships with them. We were told that staff were caring and responsive to their needs and maintained people's privacy and dignity whilst supporting them to remain independent.

The registered manager was responsive to concerns and took steps to ensure issues or concerns were addressed. The registered manager assured us that improvements were being made to the on-call system to ensure people and their relatives were informed when staff were late to arrive. Staff told us that the registered manager was responsive and provided support whenever required.

There was a complaints procedure and people knew how to use it. People and their relatives were confident that any concerns raised would be responded listened to and addressed.

The registered manager monitored the quality of service provided through regular checks on how the staff delivered care and through reviews of people’s needs. Accurate up to date records were maintained relating to the people who used the service, staff and the management of the service. Whilst the service develops a robust quality monitoring system to assess the quality of care provided, people and their relatives’ were encouraged to share their views with the registered manager individually, during routine checks and through care plan review meetings. The views and opinions of the staff were sought regularly to help develop the service.