Archived: Miracle Agency Limited

Updated 17 August 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

This inspection was carried out by 1 inspector 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.

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was announced. We informed the provider before we visited the location's office on 15 March 2023 but they were not in. The second time we visited the location's office on 12 June 2023. This inspection was delayed due to the provider not fully cooperating with the inspection team when arranging the inspection.

What we did before the inspection

We reviewed the information we held about the service including any received feedback from the local authority and intelligence information we held on our system.

The provider did not complete the required Provider Information Return (PIR). This is information providers are required to send us annually with key information about the service, what it does well and improvements they plan to make. Please see the well-led section of the full inspection report for further details.

During the inspection

We spoke with 1 person who used the service and their friend. We also spoke with the registered manager, senior care worker and 3 staff members who provided care to people. We contacted 1 healthcare professional to find out their experiences of working with this provider.

We reviewed a range of records. This included people's care plans and risk assessments, medicines management procedures and staff files in relation to training and recruitment data. A variety of records relating to the management of the service, including audits and policies were also reviewed.

Updated 17 August 2023

About the service

Miracle Agency Limited is a domiciliary care agency. It provides personal care to people living in their own homes. The service provides support to older people. At the time of our inspection there was 1 person using the service.

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

We found evidence during our inspection of multiple breaches of regulation and the need for this provider to make improvements.

People's risk assessments and medicine management records were not robust to ensure safe care delivery. Care records were not always person- centred, accurate and up to date.

People were not always supported to access information in an appropriate way for their needs. Staff recruitment practices and call monitoring systems were not always effective to ensure safe care delivery. Staff did not receive on- going support on the job to ensure they carried out their role responsibilities as necessary.

Training provided for staff was not meeting their role expectations and some staff's understanding of the Mental Capacity Act (2005) was limited. Systems and processes were not in place to effectively support people in the decision-making process.

Management arrangements in place were not sufficiently meeting the service expectations which resulted in a lack of management oversite. The provider had failed to learn lessons when things went wrong and they failed to demonstrate any improvement made since our last inspection.

Despite this, the provider followed current best practice guidelines to effectively manage risks associated with infection prevention and control (IPC).

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

Rating at last inspection

The last rating for this service was inadequate (published 19 August 2022) and there were breaches of Regulation 12 (safe care and treatment), Regulation 19 (Fit and proper persons employed), Regulation 18 (Staffing), Regulation 17 (Good governance), Regulation 14 (Meeting nutritional and hydration needs), Regulation 9 (Person centred care) and Regulation 16 (Receiving and acting on complaints) . The provider completed an action plan after the last inspection to show what they would do to improve. At this inspection enough improvement had not been made and the provider was still in breach of Regulations12, 19, 18, 17 and 9.

This service has been in Special Measures since 19 August 2022. This meant we kept the service under review and, we re-inspected the service to check for significant improvements.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Miracle Agency Limited on our website at www.cqc.org.uk.

Why we inspected

This was a planned inspection based on previous rating and when the service was last inspected.

Enforcement:

We identified 6 breaches in relation to person centred care, staffing, safe care and treatment, fit and proper persons employed, meeting nutritional and hydration needs, and good governance.

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

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 than12 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.