Background to this inspection
Updated
28 November 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. 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 Care Act 2014.
Inspection team
The inspection was undertaken by one inspector. Three inspectors made phone calls to staff members working for the provider and an Expert by Experience made phone calls to people using the service. 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 houses and flats and specialist housing.
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 service 24 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 29 September 2020 and ended on 2 October 2020. We visited the office location on 29 September 2020.
What we did before the inspection
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We spoke the local authority who commissioned care from the provider and reviewed any notifications sent to us by the provider. We used all of this information to plan our inspection.
During the inspection
We spoke with the registered manager, the nominated individual and nine staff members. We also spoke with 13 people or their relatives.
We reviewed six care plans and associated risk assessments and daily records. We reviewed two people’s medicines. We checked six staff recruitment files and training records and looked at policies and procedures, safeguarding, complaints and audits to monitor and improve the service.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two professionals prior to the inspection who have regular contact with the service
Updated
28 November 2020
About the service
Kare Plus Altrincham and Trafford is a domiciliary care service providing personal care and the treatment of disease, disorder and injury to older people, younger adults, learning disabilities and autistic spectrum disorder and people living with dementia. 41 people were using the service 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
People were not always receiving timely visits from staff to support them at home. This was evident from the phone calls we undertook with people and their families and call logs. While the provider had identified this concern, people were still receiving support from staff up to an hour earlier or an hour later than scheduled. The variation between the times of calls also put people at risk of receiving their medicines without the required intervals. There was further evidence one person was not receiving a time specific medicine within the correct time frames. Some staff felt they were not given enough time to travel from one property to another which impacted upon the call times for people. Risks to people were assessed, monitored and reviewed. Staff were aware of safeguarding procedures and how to report any concerns.
The management team had identified where people had been receiving untimely calls and had tried to remedy the issue. We made a recommendation; the provider reviews all scheduled calls to ensure they are at people’s commissioned time and incorporate timely gaps between the calls if this is appropriate. We also recommended staff travel times are reviewed to ensure staff have enough travel time in-between each visit. Following the inspection, the provider instigated further processes to manage the rota more effectively. Audits were in place to monitor and improve the service and while some audits had identified shortfalls, concerns around the timeliness of medicines being administered had not been highlighted and rectified. People, their relatives and staff gave mixed responses on the support the provider gave.
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 good (published 6 April 2018).
Why we inspected We received concerns in relation to late and missed calls and inconsistency staff teams supporting people. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We did not find any evidence of missed calls.
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.
We have found evidence that the provider needs to make improvement. 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 Kare Plus Altrincham and Trafford on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.