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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

All Inspections

20 January 2020

During a routine inspection

About the service

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.

14 February 2018

During a routine inspection

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.