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Archived: Italia House

Overall: Inadequate read more about inspection ratings

Unit 7, Italia House, Pass Street, Oldham, Lancashire, OL9 6HZ 0333 014 3086

Provided and run by:
Passion Carers Ltd

Latest inspection summary

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Background to this inspection

Updated 2 April 2020

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 carried out by an inspector and an inspection manager.

Service and service type

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.

Notice of inspection

The inspection was announced. We gave the service 48 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 20 January 2020 and ended on 3 February 2020. We visited the office location on 20 January 2020.

What we did before the inspection

We reviewed the information we held about the service. This included the inspection report from our last inspection. We used this information to plan our 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.

During the inspection

We spoke with two relatives of the person who used the service. We also spoke with the registered manager, who was providing the majority of care to this person, and one other support worker.

We reviewed care records. We also looked at some policies and other documents relating to the management of the service, including training records and policies. There was limited documentation for us to review.

Overall inspection

Inadequate

Updated 2 April 2020

Italia House is a domiciliary care agency which provides care and support to people living in their own homes in the community. The care agency offers a variety of services, including assistance with personal care, meal preparation and domestic tasks. Not everyone using Italia House receives a regulated activity. The Care Quality Commission (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.

This was the first inspection of this service, which had registered with CQC in July 2017. At the time of our inspection Oldham Metropolitan Borough Council (OMBC) had cancelled all their care contracts with the service. This was following a number of concerns raised by people who used the service and their families about aspects of the care they had received. These included concerns about late and missed visits, poor record keeping and poor medicines documentation. Although OMBC had cancelled all its contracts it should be noted that not all people were dissatisfied with the care they had received. At the time of our inspection the service was providing care to one person through a care package which was privately funded. However, we looked at the information held by the service about all the care provision since they started providing support since December 2017 to allow us to gain a view about the service.

We carried out this announced inspection on 14 February and 12 March, 2018. The service had a registered manager. A registered manager is a person who has registered with CQC 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.

We found breaches of four of the regulations of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulation 2014. These are in relation to medicines management, risk assessments, staffing, need for consent and quality assurance.

You can see what action we told the provider to take at the back of the full version of the report.

Medicines were not managed safely. The limited medicines documentation that was available for us to check was poorly and incorrectly completed. There was also no information available for staff to guide them when giving ‘as required’ medicines.

Many concerns had been raised with OMBC about late and missed visits. These are currently being investigated as part of OMBC’s safeguarding investigations. From the information we have received we consider the service did not have sufficient staff to provide the care it had agreed to undertake.

Although some risk assessments had been carried out, particularly in relation to people’s environment, we found that individual risk assessments, for example for moving and handling and nutrition, had not always been undertaken.

Recruitment checks had been carried out to ensure staff were suitable to work with vulnerable people. However, references had not been checked or validated to ensure they were genuine.

Staff employed had received an induction to the service and essential training. Staff had received supervision.

There was no evidence that people’s mental capacity had been assessed. There was no information to show who was involved with making decisions about peoples’ care and no evidence to show that care plans had been discussed and agreed with people using the service or their family member/legal representative.

The systems in place to ensure care was provided in a safe way were not sufficiently well established. No auditing or checking of the service had been carried out. The inspectors found there was a significant lack of documentation available to them during the two day inspection. This absence of key information was of concern because they were unable to satisfy themselves that the service being provided was appropriate, adequate or safe. Despite discussions with the registered manager and explanations of what was needed, they failed to provide satisfactory documents or assurances.

The overall rating for this service is 'Inadequate' and the service is therefore in 'special measures'. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This may lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions, it will no longer be in special measures.