We undertook an announced inspection of Cardea Healthcare Ltd on 6 March 2018. The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to be sure that someone would be available.This was the first inspection of the service since it registered with the CQC on 20 May 2017.
Cardea Healthcare Ltd is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It also provides live in care workers to support people during the day and at night. At the time of the inspection it provided a service to six people who required a 24 hour package of care and home care visits for two people. These care packages were funded by the local authority and clinical commissioning group.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. The registered manager was also a director of the company. 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.
Risk management plans for some of the risks identified during the needs assessment were not in place for people. Therefore, care workers were not provided with written guidance on how to reduce these risks.
The provider had a process in place for the administration and recording of medicines. However, there were no protocols for the administration of medicated creams or PRN (as required) medicines.
There was a process in place for recording and investigating incidents and accidents but actions were not always recorded where these had been identified to prevent reoccurrence.
There were a range of checks carried out in relation to the service but some of these were not effective because these had not identified the areas for improvement we found during our inspection.
The provider had a process in place in relation to the Mental Capacity Act 2005 but was not always working within the principles of the Act to ensure people could consent to their care or that decisions were made in their best interests. We made a recommendation to the provider regarding this issue.
The provider had an effective recruitment process in place and the number of care workers required to provide appropriate care for a person was based on the assessment of the person’s needs.
People using the service and relatives felt the service was safe and the provider had a procedure for the reporting and investigation of safeguarding concerns which they followed.
An assessment of a person’s care and support needs was carried out before they started to receive support from the service.
Care workers received the necessary training and support to deliver care safely and to an appropriate standard.
The care plans identified each person’s wishes as to how they wanted their care provided. People were supported to enjoy a range of activities in their home and in the community.
There was a complaints procedure and people were aware how to raise concerns.
People using the service, relatives of people being supported and care workers felt the service was well-led and effective. Care workers felt supported by the registered manager.
We found breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These breaches relate to the safe care and treatment of people using the service (Regulation 12) and good governance (Regulation 17). You can see what action we told the provider to take at the back of the full version of this report.