Archived: Homestead Care

Updated 30 November 2021

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 one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

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

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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. We used all this information to plan our inspection.

During the inspection-

We spoke with five people who used the service and four relatives about their experience of the care provided. We spoke with eight members of staff including the provider/registered manager, deputy manager, office manager, senior care workers and care workers.

We reviewed a range of records. This included five people’s care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We met with the provider to follow up on some concerns and ask them to respond to our questions. We looked at safeguarding and accident and incident records.

Updated 30 November 2021

About the service

Homestead Care is a domiciliary care agency that was providing personal care to 14 older adults living in their own homes at the time of our inspection. 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

Systems and processes to protect people from preventable harm were not always operating effectively. Safeguarding concerns had not always been shared with external organisations which meant risks to people did not always have the right level of oversight.

The service had not made statutory notifications to CQC as required. A notification is the action that a provider is legally bound to take to tell CQC about any changes to their regulated services or incidents that have taken place in them.

People were supported by a staff team who understood how to recognise and report safeguarding concerns. Risks to people were assessed, monitored and regularly reviewed and staff understood actions needed to minimise risk of harm. Staff recruitment included employment references and a criminal record check to ensure applicants were suitable to work with older people. People received their medicines safely. Infection, prevention and control practices were in line with government guidance.

Staff spoke positively about their roles, felt their opinions mattered and were supported by the management team. Quality assurance processes captured the voice of people using the service and enabled improvements. Partnerships with other health and social care agencies supported best practice and positive outcomes for people.

The registered manager told us challenges during the pandemic had led to difficulties recruiting staff and a reduction in the number of people they supported with care. This had meant the financial viability of the service was under review and they were making difficult decisions about the future of the business.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 18 December 2019).

Why we inspected

We received concerns in relation to the management of medicines, safeguarding and governance. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Homestead Care on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safeguarding people and not meeting regulatory reporting requirements. Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service. The provider told us they had informed people, staff and the local authority of plans to close the service due in part to staffing issues arising out of the COVID-19 pandemic. We will continue to liaise with the service and the local authority around the issues raised and the potential closure of the service.