Archived: Kare Plus Portsmouth

Updated 15 January 2020

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The focussed inspection took place to review the providers progress in relation to a warning notice that was issued following the last inspection which was published in November 2018.

This inspection focussed on Safe and Well-Led domains.

Inspection team:

This inspection was carried out by one inspector.

Service and service type: Kare Plus is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older adults and younger adults who may be living with a disability or sensory impairment. At the time of inspection, the service was delivering personal care to 48 people living in their own homes. Not everyone using Kare Plus Domiciliary Care Agency received a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

We gave the provider 24 hours’ notice of the inspection site visit to ensure that the registered manager would be present, and to ensure people’s consent was gained for us to contact them for their feedback.

What we did:

Prior to the inspection we reviewed any notifications we had received from the service. A notification is information about important events which the service is required to tell us about by law. We also reviewed any information about the service that we had received from external agencies. We assessed the information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

This inspection included speaking with two relatives, four members of staff, the registered manager and one professional. We attempted to speak to people however, many were unable to speak to us and some requested that we did not contact them. We requested contact details for more people from the registered manager however we did not receive this information. We reviewed records related to the care of five people. We reviewed recruitment files for two staff. We looked at records relating to the management of the service, policies and procedures, quality assurance documentation and complaints information.

We asked for further information following the inspection including the end of life policy and supervision policy and these were received. We also asked for information about bespoke training that staff had completed. We received an example book showing what additional training staff undertook however, the provider did not have a matrix identifying who had completed this additional training.

Updated 15 January 2020

About the service: Kare Plus Portsmouth is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older and younger adults who may be living with a disability or sensory impairment. At the time of inspection, the service was delivering personal care to 48 people living in their own homes.

People’s experience of using this service:

Insufficient improvement had been made since our last inspection. Medicines management remained unsafe. People's medication records did not always reflect that they were administered safely. It was not always clear that people received their medications as prescribed. Risk assessments continued to lack enough information to provide direction for staff, or information about how to reduce risks.

The registered manager had conducted some quality assurance audits to monitor the running of the service. However, these were not always effective, records did not always reflect these were used to monitor, assess and improve the quality of the service being delivered.

Despite this people’s relatives told us they felt their family member was safe. There were some systems in place to protect people from the risk of abuse and potential harm. Staff were aware of their responsibility to report any concerns they had about people's safety and welfare.

People’s relatives and staff knew the registered manager and felt able to speak to them if they had any concerns. The registered manager demonstrated a willingness to make improvements and had recently employed a staff member who would be responsible for carrying out monthly audits.

Rating at last inspection: The service was rated Requires Improvement at their last inspection. (Report published 7 November 2018)

Why we inspected: At our last inspection we found Kare Plus Portsmouth was in breach of Regulation 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 because they had not ensured the safe management of medicines, risks for people had not been assessed and plans implemented to reduce these and governance was poor meaning issues of concern were not being identified. We served a warning notice to the provider requiring them to be compliant with Regulation 12 by the 25 January 2019 and issued a requirement notice for regulation 17. We carried out this focussed inspection to check whether Kare Plus had acted to meet the warning and requirement notices issued at the inspection in November 2018.

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

Follow up: We identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and because this is the second consecutive time the service has been rated as requires improvement we will request a clear action plan from the registered person on how they intend to achieve good by our next inspection. We may decide to meet with the provider following receipt of this plan. We will continue to monitor all information received about the service to understand any risks that may arise and to ensure the next inspection is scheduled accordingly.

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