20 January 2020
During a routine inspection
Italia House is a domiciliary care service. It provides care and support to people in their own homes. At the time of our inspection the service was supporting one person. Not everyone who uses domiciliary care services receives 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.
We last inspected the service in February and March 2018, when it was supporting one person with personal care. Shortly after our inspection the person discontinued their care package and the service became dormant. In October 2019 the service again started to provide support to one person. Only two members of staff provided support to this person. One of these was the registered manager. We have been unable to allocate a rating to our key questions to give an overall rating as there was insufficient service history and evidence for us to form a judgement.
People’s experience of using this service and what we found
Relatives of the person were happy with the support provided by Italia House.
Care plans contained some information about the person’s preferences, medical history and support needs. Some risk assessments were in place. However, there were no risk assessments for key areas, such as mobility and accessing the community.
No new staff had been employed since our last inspection, so we were unable to review recruitment procedures or staff induction. The majority of care was provided by the registered manager. One other person carried out support visits. They had completed refresher training in a variety of relevant subjects.
We were unable to assess how medicines were managed, as no one was receiving support with medicines.
Staff had been trained in infection prevention and control and had the appropriate personal protective equipment, such as gloves and aprons, to wear when carrying out personal care tasks.
The service had not received any complaints.
We have made a recommendation about how the service manages people’s communication needs.
People were helped to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
The registered manager liaised with health professionals. However, other partnership working was limited.
Quality assurance processes were being developed to monitor the quality of the service. However, they were not yet established.
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 inadequate (report published 24 May 2018) and there were multiple breaches of regulations. The provider completed an action plan after the 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 regulations 12 and 17.
This service had been in Special Measures since May 2018. At this inspection we have been unable to provide a rating for the service, due to lack of evidence and insufficient service history. The service therefore remains in Special Measures. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
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.
Why we inspected
This was a planned inspection based on the previous rating and because the service was no longer dormant.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement
We have identified breaches in relation to managing risk and the governance of the service. 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. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.