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ICare (GB) Limited - Runcorn Requires improvement

This service was previously registered at a different address - see old profile

Reports


Inspection carried out on 15 March 2021

During an inspection looking at part of the service

About the service

I Care (GB) Limited is a domiciliary care agency providing personal care to adults in their own homes. The service was supporting 80 people at the time of the inspection.

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

The service was not well-led. We found significant shortfalls in how the service was managed.

Assurance processes and systems were not robust enough to provide adequate overview and did not always mitigate risk to the health and welfare of people using the service.

Although people told us they were happy with the care being provided, because risk was not appropriately managed, this meant people were sometimes exposed to a risk of harm.

Some people, including those with more complex needs, did not have a care plan in place. What paperwork was in place, did not always reflect their current care and support needs and provided staff with insufficient guidance on how to support people safely.

People told us staff sought their consent, though care records did not always reflect that people had provided consent to their care and treatment or had been involved in the creation of their care plan.

There was ineffective oversight of training for staff. Staff had not completed all mandatory training, including medication and COVID-19 training, to ensure they were competent in their roles. However, some gaps in staff training had been identified by the registered manager and training sessions had been booked.

We have made a recommendation about staff deployment to help ensure more effective covering of calls.

The registered manager began to address our concerns immediately following the inspection, showing they were responsive to making the required improvements, and that the safety and quality of the service was a priority.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection

This service was last inspected on 11 February 2018 and rated Good (report published 11 April 2018.)

Why we inspected

The inspection was prompted in part due to concerns received about a lack of care plans, risk assessments and medicines management. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment, consent 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 request an action plan for the provider to understand what they will do to improve the standards

Inspection carried out on 8 February 2018

During a routine inspection

This inspection took place on 8, 9 and 15 February 2018. The inspection was announced, which means the provider was given 48 hours’ notice as we wanted to make sure someone would be available. This inspection was conducted by an adult social care inspector and two experts by experience who completed a series of phone calls to people in their homes on the second day of our inspection.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults, and younger disabled adults. The service was re-registered by CQC last November due to a change of legal entity. This was the services first inspection under the new provider’s registration.

There was a registered manager 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.

Everyone we spoke with said they felt safe receiving a service from I care.

Staff were able to describe the process they would follow to report actual or potential abuse, this mostly consisted of reporting the abuse to the line manager. The service had a safeguarding policy in place, which we viewed and staff we spoke with told us they were aware of the policy. Safeguarding training took place as part of the induction for new staff, and was refreshed every year. The service reported and acted upon 'care concerns' and demonstrated that they had implemented lessons learned from any issues raised.

Risk assessments were in place and were reviewed often or when people's needs changed. We did highlight at the time of our inspection that some risk assessments would benefit from being more personalised.

Staff recruitment records showed that staff were recruited safely recruited after a series of checks were undertaken on their character and work history.

People were supported with their medication in accordance with their assessed needs.

Staff were supplied with personal protective equipment (PPE). This included gloves, aprons and hand sanitizer. Staff we spoke with told us they were always able to ask for more PPE when needed. Staff had completed infection control and prevention training, and understood the important of reporting outbreaks of flu and vomiting to the registered manager, so they could cover their work so as not to spread the infection.

The registered manager and the staff understood the principles of the Mental Capacity Act 2005 and associated legislation. However, documentation was lacking in some areas with regards to consent and best interests in general. We have made a recommendation about this.

Staff undertook training in accordance with the providers training policy. Staff told us they enjoyed the training.

People were supported as part of their assessed care needs with eating and drinking, and staff documented what people ate and drank to ensure they were getting access to adequate nutrition and hydration.

Staff supported people to access other healthcare professionals such as GP’s and District Nurses if they felt unwell. We saw in most cases family members would do this for their relative; however, staff were able to describe some occurrences when they had to call other medical professionals, such as 111 for advice on someone’s behalf.

We received positive feedback regarding the caring nature of the staff.

People said they were supported to make decisions regarding their care and treatment and they were able to chat with the staff when they came to their homes.

Care plans contained detailed information about people, what their preferences were, and how they liked their routine to be conducted. Information in care plans was regularly reviewed and updated in line with people’s