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Independent People Homecare Services Limited Inadequate

Reports


Inspection carried out on 2 November 2020

During a routine inspection

About the service

Independent People Home Care Limited is a domiciliary care agency providing personal care to people in their own home. This included a nationwide, 24-hour live-in care service. At the time of the inspection there were 115 people using the service.

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

Staff were providing care to people with complex and extensive care needs. People told us they were not always supported by staff who had the correct skills, knowledge or competence to meet their assessed needs. Some staff told us they needed more training, and that whilst they had been given training this did not adequately meet their learning needs.

We could not be assured when training had been provided to staff that it was carried out by suitably qualified people and was adequate to meet some people's complex needs. Systems were not in place to ensure staff would be appropriately supervised when they were learning new skills but were not yet competent to carry out the task.

Staff had been given training to administer people's medicine. We could not be assured they were competent to undertake the task, as the registered manager had not carried out a competency assessment.

The registered manager told us medicine audits were carried out, but when we requested to see this information, this was not provided.

We found a number of safeguarding incidents which had not been raised with the relevant authorities by the registered manager. Shortly after our inspection, the registered manager confirmed these had been reported. Risk assessments were in place, but for some people these were not comprehensive and did not include an assessment of all of the tasks staff needed to carry out.

The registered manager did not record information relating to missed and late visits and this was not available for us to review. Some relatives told us arrangements to enable staff to take breaks when providing 24-hour live-in care, were not formalised by the care agency and that it was often left to the relative or family member to oversee and arrange. Some staff who provided 24-hour live-in care to people told us they did not always get their breaks.

We have made a recommendation about the environment of the premises.

The leadership of the service did not always support the delivery of high-quality, person-centred care. There was a lack of consistency in how well the service was managed and led. Whilst the COVID-19 pandemic may have impacted on the registered managers ability to carry out routine spot checks. People told us the registered provider made phone calls to check the quality of the service they had received, but that this system was ineffective to address the issues we found. Systems to monitor and check the quality of the service people received were ineffective because, they did not identify the issues we found.

Some people told us communication between themselves and the office was poor and needed to improve. Most people said that once a staff member had been placed in the home, limited checks were carried out. The registered manager had delegated some of their oversight tasks to field care supervisors, and at the time of the inspection, they had two vacancies for these posts. We could not be assured there were adequate systems in place to monitor the service because robust and effective audits were not consistently carried out, to monitor the quality of the service people received.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies in the service supported this practice.

We looked at infection prevention and control measures under the Safe key question. We have recommended that the service improves their current infection and prevention control measures.

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

Rating at last inspection

The

Inspection carried out on 9 October 2018

During a routine inspection

This inspection took place on the 09 October and 10 October 2018 and was announced.

This service is a domiciliary care agency. It gives personal care to people living in their own houses. It provides a service to older adults. On the day of our inspection, there were 139 people using the service, all of which received personal care.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the ongoing rating of good. There was no evidence or information from our inspection that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At the time of inspection 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 and associated Regulations about how the service is run.

People were safe at the service. Staff knew what action to take if abuse was suspected. Some people told us that they had experienced missed or late visits on occasions. We have made a recommendation about missed and late visits. A robust recruitment and selection process was in place.

Staff had a good understanding of how to manage medicines. People's medicines were managed so that they received their medication at the right time and in the right way.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff were kind and had developed good relationships with people using the service. People told us they were comfortable in the presence of staff. People told us staff were caring and looked after them well. People were provided with the care, support and equipment they needed to stay independent.

Systems were in place to manage compliments and investigate complaints. Staff understood the importance of supporting people to have a good end of life as well as living life to the full whilst they were fit and able to do so. End of life care plans include people's wishes to ensure that people’s passing was comfortable, pain free and as peaceful as possible.

People were involved with care planning and staff knew people well and were aware of their personal histories. Positive relationships had developed between people and the staff that supported them. Information included guidance for staff so they could follow a structured approach to recognise and manage people’s health conditions and behaviour.

Robust systems were in place to seek the views of people who used the service, and check the quality. Spot checks, care planning review meetings and audits were carried out on a regular basis. Feedback about the service was used to review the service and to make improvements.

Further information is in the detailed findings below.

Inspection carried out on 11 August 2016

During a routine inspection

Independent People Homecare is a domiciliary care agency (DCA) which provides care and support to people in their own homes. At the time of our inspection ninety people were using the service.

The inspection took place on 11th August 2016 and was announced. 48 hours' notice of the inspection was given because we needed to be sure that the registered manager would be available. The last inspection of this service took place on 13th February 2014 and at that time the service was meeting all the required standards inspected.

At the time of inspection 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 and associated Regulations about how the service is run.

People were safe at the service. They were protected from harm by staff who were aware of their safeguarding responsibilities. Staff understood what constituted abuse and knew what take action if abuse was suspected.

People had risk assessments and risk management plans in place to guide staff on how care was to be provided in order to prevent or minimise the risk of people coming to harm.

People were supported to manage their medicines by staff who were trained and assessed as competent to give medicines safely

Systems and processes were in place to ensure the safe recruitment of staff with sufficient numbers of staff employed to safely meet people’s needs

Staff had access to relevant training and regular supervision to equip them with the knowledge and skills to care and support people effectively.

The legal requirements of the Mental Capacity Act 2005 (MCA) were followed when people were unable to make specific decisions about their care. The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves.

People were supported to have enough to eat and drink which met their personal preferences and any health needs. The service worked with health and social care professionals when staff had concerns about people’s health and wellbeing.

People’s care plans were reviewed regularly. People were involved in the care planning process and in decisions about their care and treatment.

Staff were kind and caring and treated people with dignity and respect.

Care was tailored to meet people’s individual needs. Care plans detailed how people wished to be supported.

There were procedures in place to support people if they wished to complain or raise concerns about the service.

The provider had systems in place to monitor the quality and safety of the service provided.

Feedback from staff and people who used the service was sought and the information was used to drive improvements.

Staff felt well supported by the management team who they found approachable and accessible.