Care 4 Care Headquarters

Updated 6 September 2022

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

The inspection was carried out by an 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

Care 4 Care Headquarters 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 who is also the owner.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the registered manager would be in their office to support the inspection.

Inspection activity started on 20 July 2022 and ended on 22 July 2022. We visited the provider’s office on 20 July 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with the registered manager/owner and care coordinator when we visited their office. We also sought telephone and/or email feedback from relatives, various community health and social care professionals and staff about their experiences of using, working with or for this provider. We received comments from seven relatives, two community health and social care professionals and three care workers.

Records we looked as part of this inspection included, six people’s care plans, six staff files in relation to their recruitment, training and supervision, and a variety of other records relating to the overall management and governance of the agency.

After we visited the provider’s office we continued to seek clarification from them to validate evidence found. We requested the provider send us additional evidence after our inspection in relation to staff training in respect of mental capacity and DoLS, autism and mental health awareness.

Updated 6 September 2022

About the service

Care 4 Care Headquarters is a domiciliary care agency providing personal care to people living in their own homes. At the time of our inspection 46 people were receiving a home care service from this provider.

The Care Quality Commission (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

The service was not always safe. Staffs scheduled visits were not always well-coordinated and managed. This meant people did not always receive their personal care and support on time from the same group of staff who were familiar with their needs, preferences and daily routines.

The service was not always responsive. People’s complaints and concerns were dealt with by the provider, but this was not always done in an open and transparent way. We have made a recommendation about the provider records how they manage complaints.

The service was not always well-managed. At our last inspection the provider had failed to consistently maintain all the records they were expected to keep and ensure they were made easily accessible on request. We discussed these recording issues with the provider at the time and at this inspection we found some improvements had been made. However, these were not enough and further improvements were still required, especially in relation to how the provider recorded the outcome of complaints they had investigated.

In addition, the provider did not always operate their governance systems effectively because they had failed to identify and/or take appropriate action to address a number of issues we found during this inspection an described throughout this report.

People were kept safe from abuse and risks they might face were suitably assessed and managed. Staffs fitness to work in adult social care had been thoroughly assessed. Staff followed current best practice guidelines regarding the prevention and control of infection, including those associated with COVID-19.

People were care for and supported by staff who were suitably trained and supported to effectively perform their roles and responsibilities. Assessments of people's support needs and wishes were carried out before they started receiving any support from this provider. 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 and systems in the service supported this practice. Where staff were responsible for preparing people's meals and/or assisting them to eat and drink, people were supported to access food and drink that met their dietary needs and wishes. People were supported to stay healthy and well, and to access relevant community health and social care services as and when required.

People's care plans were person-centred, which helped staff provide them with the individualised home care and support they needed. Staff ensured they communicated and shared information with people in a way they could easily understand. People were encouraged to make decisions about the care and support they received at home and staff respected their informed choices. Where appropriate, people's end of life wishes and contacts were known and recorded for staff to refer to.

The relatives of people using the service, community health and social care professionals and staff who worked for this provider were complimentary about the way the registered manager/owner ran the service. The registered manager promoted an open and inclusive culture which sought the views of people using the service, their relatives and staff. The provider worked in close partnership with other health and social care professionals and agencies to plan and deliver people's packages of home care.

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

Rating at last inspection and update

The last rating for this service was good (published 18 April 2018).

At our last inspection we discussed with the provider their record keeping, which needed to be improved. At this inspection we found the provider had made some progress to improve how they maintained records they were expected to keep however, further improvements were still required.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at our last inspection. The inspection was also prompted in part due to concerns received about staff recruitment and punctuality. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements to the way they coordinate staff home care visits, records how complaints are managed and how they operate their quality monitoring systems.

We found no evidence during this inspection that people had been harmed however, the failures described above had placed people at risk of being harmed. The overall rating for the service has therefore been changed from good to requires improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Care 4 care Headquarters on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified two breaches at this inspection in relation to how the provider coordinated staffs home care visits and manages their governance and record keeping systems.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.