Updated 13 May 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 2 inspectors and 2 Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of service.
Service and service type
City Care Agency is a domiciliary care agency. It provides personal care to people living in their own homes.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the provider 2 days’ notice because we needed to ensure they would be available to assist us with the inspection.
Inspection activity started on 6 March and ended on 3 April 2023. We requested a range of documents that were sent to us by the provider between 6 March and 16 March 2023. We visited the office location on 9 and 14 March 2023 to see the registered manager and to review further records related to the service. We made calls to people, their relatives and care staff between 15 March and 22 March 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. This included any significant incidents that occurred at the service. The provider was not asked to complete a recent Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
We contacted the local authority commissioning team and reviewed the previous inspection report. We also reviewed the information of concern that had been shared with us that led us to carry out this focused inspection. We used all of this information to plan our inspection.
During the inspection
We reviewed a range of records related to 11 people’s care and support. This included people’s care plans, risk assessments, medicines records and 8 staff files in relation to recruitment. We reviewed records related to the management of the service, which included safeguarding incidents, quality assurance records, minutes of staff meetings and a range of policies and procedures.
We also reviewed electronic call monitoring (ECM) data for 87 people for the month of February 2023. An ECM system is where care workers log in and out of their calls, and the information is recorded.
We spoke with 6 staff members. This included the registered manager, the office manager and 4 care coordinators.
We contacted a number of care workers, via email and telephone. We also asked the registered manager to share a questionnaire with all active care workers to give them an opportunity to give us feedback about their experience of working for the service. We received feedback from 40 care workers.
We contacted 45 people and managed to speak with 12 people and 13 relatives. We also spoke with 3 health and social care professionals who had experience of working with the service.
We continued to seek clarification from the provider to validate evidence found after the inspection. We looked at further quality assurance records, accidents and incidents, a service improvement plan and correspondence with a range of health and social care professionals related to pe