We carried out a review of the data available to us about Cardinal Care Services Ltd on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Cardinal Care Services Ltd, you can give feedback on this service.
Cardinal Care Services is a domiciliary care services providing personal care and support to people in their own homes. At the time of the inspection it was providing personal care to eight people. 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 and relatives said they felt safe and comfortable in the presence of staff and fully trusted them. Risks to people’s health and safety were assessed and mitigated. The service had enough staff and provided a timely and reliable service. Medicines were managed in a safe and proper way.
People received effective care from staff who knew them well. Staff received a good level of training and were well supported by the management team. People were supported to eat well. The service understood people’s healthcare needs and liaised with appropriate healthcare organisations to ensure they were met.
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.
Staff were kind and caring and treated people well. People had a small team of care workers who developed strong relationships with them. People were always introduced to new care workers and staff let people know if they were going to be late. People were respected and treated with dignity by the service.
People’s needs were fully assessed, and clear and detailed care plans were in place. The service provided high quality care, with staff arriving on time and not rushing them. The service was aware of people’s cultural needs and beliefs and ensured they were fully catered for. People found the registered manager approachable and willing to address any concerns or queries they had.
The service had significantly improved since the previous inspection with management support brought in to improve the quality of documentation. The registered manager was knowledgeable about people and how the service operated. A range of audits and checks were undertaken, and people’s feedback was sought to aid continuous improvement of the service.
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 requires improvement (published 18 July 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
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.
Cardinal Care Services Ltd is registered as a domiciliary care agency providing the regulated activity ‘personal care’ to people who live in their own homes. At the time of our inspection, the service was providing personal care to nine people.
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:
Whilst we found no evidence to suggest medicines were not administered safely, records related to medicines management were not well maintained or robust. People’s potential areas of risk had not been assessed. The registered manager and most staff had not completed safeguarding training. The recruitment system was not robust. Staff did not receive appropriate training necessary to enable them to deliver effective care and support.
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. However, the assessment of people’s mental capacity was not fully understood by the registered manager and the recording of mental capacity assessments was not detailed.
Care plans lacked appropriate detail and were not always up to date. The provider did not have effective systems in place to assess, monitor and improve the quality of service provided. Complete, accurate and contemporaneous records were not kept. People and relatives were asked for their views; however, these were not recorded.
People and relatives told us they felt safe in their home and with staff. There were enough staff to meet people’s needs. Staff followed infection prevention and control practices when supporting people in their own homes. Lessons had been learnt from issues identified by staff.
An induction was completed by all staff and staff received support to enable them to perform their roles effectively. Staff involved healthcare professionals to support people's health needs where required. People received support, with eating and drinking, when needed.
People and relatives said staff were reliable, kind and caring. Staff understood how individual people preferred their care and support delivered and the importance of treating people with dignity and respect. The service was not supporting anyone who was at the end of their life.
The provider worked in partnership with other services to support people’s care and quality of life. For example, Leeds Black Elders Association. There was a system in place to respond to any complaints.
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:
At the last inspection the service was rated Requires Improvement (report published 20 June 2018). The rating at this inspection had remained the same. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection not enough improvement had been made and the provider was still in breach of regulation 17.
Why we inspected:
This was a planned inspection based on the previous rating. We have found evidence the provider needs to make improvements. Please see the safe, effective, responsive and well-led sections of this full report.
Enforcement: We have identified a breach in relation to record keeping and governance of the service at this inspection. Please see the ‘action we have told the provider to take’ at the end of this report.
Follow up:
We will 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 also request a monthly action plan from the provider to monitor improvements being made. 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.
This service is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to older adults and at the time of this inspection the service were supporting three people.
Not everyone using Goshen'09 Business Centre received regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. We spoke with the registered manager regarding the name of the service and they told us the service was actually called Cardinal Care Services as Goshen'09 Business Centre was the name of the building the service was located.
There was a registered manager in post at the time of our inspection. 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 2008 and associated Regulations about how the service is run.
Medicines management was not always safely managed; there was no system in place to ensure people received their medicines as prescribed. Staff received training in medicine management but we were unable to evidence an assessment of staffs competency to administer medicines had been completed. When necessary staff involved community nurses, GP's or the emergency services to make sure people's health care needs were met.
People we spoke with told us they felt safe with the staff and the care and support they received. We found there were appropriate systems in place to protect people from risk of harm. Although, the registered manager’s knowledge around safeguarding procedures and reporting incidents to the local authority safeguarding team and the Care Quality Commission (CQC) required strengthening.
People who used the service said their visit times suited their wishes and staff always arrived on time and stayed the agreed length of time. We saw sufficient staff were employed to cover people’s allocated visits. Recruitment procedures were not always robust as not all necessary information had been recorded by the registered manager.
Staff had opportunities for on-going development, although there was no mechanism in place to ‘knowledge check’ staff members to make sure their learning was robust. The registered manager ensured new staff received an induction but said they were behind with staff supervisions.
People were not supported to have maximum choice and control of their lives. The registered manager had not completed mental capacity assessment where required.
People and relatives we spoke with told us they were very happy with the service they received and staff were reliable, kind and caring, treated them with dignity and respected their choices. The registered manager told us, currently, the service did not provide care and support for people whose primary need was end of life care. People received assistance with meals and healthcare when required.
The staff we spoke with were able to describe how individual people preferred their care and support delivered. The care plans we looked at contained details of people’s preferred routines, visit times and information about people’s health and support needs, although we noted some areas could be more person centred.
There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or support they received. Although, these were investigated by the registered manager, they were not documented.
People who used the service, relatives and staff we spoke with were very positive about the registered manager. They said the registered manager was hands on, approachable and responsive.
We found effective systems to monitor and improve the quality of the service provided we not in place. People who used the service and family members were able to offer their opinion about the service as the registered manager spoke with them on a regular basis.
We found three breaches of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of the report.