Background to this inspection
Updated
14 September 2019
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 and one assistant inspector.
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
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. However, the registered manager had been absent from the service.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 3 July 2019 and ended on 11 July 2019. We visited the office location on 3 July 2019.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We reviewed information we had received about the service since the last inspection. This included information which the provider had sent to us as part of the conditions placed upon their registration. These records included recruitment checks for two staff, medicines records and care records. We used all of this information to plan our inspection.
During the inspection
We spoke with two staff. We reviewed a range of records including risk assessments and medicines records for one person and one staff recruitment file.
After the inspection
We spoke with one person and sought feedback from the local authority.
Updated
14 September 2019
About the service
JKs Majestical Care Limited is a domiciliary care agency providing personal care to one person in their own home at the time of the inspection.
People’s experience of using this service and what we found
The person using the service told us they were happy with the service provided.
People could not be assured that staff were safe to work with them as the appropriate pre-recruitment checks were not carried out.
People were not always supported by staff who had been trained about safeguarding and abuse. Some staff did not have training in infection control. People were at risk of not having their needs met by staff who were not suitably trained in their role.
Staff did not have adequate knowledge of one person’s medical healthcare needs, although they were supported with their medicines appropriately.
The provider did not have effective systems and processes in place to ensure good governance of the provision of care for people. Shortfalls we had identified at our last inspection had not been addressed and we identified a lack of improvement.
Staff worked with other professionals to ensure they could support people’s care needs.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
The last rating for this service was requires improvement (published 4 May 2019) and there were three breaches of regulations. We placed conditions on the provider’s registration which required the provider to send us monthly audits to support them to improve the standards of quality and safety. At this inspection, not enough improvement had been made and the provider was still in breach of regulations. The service remains rated requires improvement.
Why we inspected
The inspection was prompted due to concerns about the safe recruitment of staff and the absence of the registered manager, who is also the provider. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We have found evidence the provider needs to make improvements. Please see the safe and well-led sections of this full report.
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.
Enforcement
We have identified continued breaches in relation to the safe recruitment of staff and the lack of an effective management structure. We identified a new breach regarding the safeguarding knowledge of staff to keep people safe and the lack of an effective management structure at this inspection.
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
We will write to the provider to ask them what action they are proposing to take to improve the standards of quality and safety and address the regulatory breaches we found. We will continue to monitor progress through the audits the provider is required to submit to us each month.
We will also meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.