Background to this inspection
Updated
22 December 2022
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 Health and Social Care Act 2008.
Inspection team
The inspection team consisted of two inspectors and two Experts 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.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
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 unannounced.
What we did before the inspection
Prior to the inspection we reviewed information and evidence we already held about this service, which had been collected via our ongoing monitoring of care services. This included notifications sent to us by the service. Notifications are changes, events or incidents that the provider is legally obliged to send to us without delay. This information helps support our inspections.
During the inspection
We spoke with 14 relatives of people who used the service to help us understand the experience of people who could not speak with us. We also spoke with 14 people using the service. We spoke with the registered manager, two care coordinators, quality assurance officer, field supervisor and nine care workers. We reviewed the care records of 12 people using the service, personnel files of eight care workers and other records about the management of the service.
Updated
22 December 2022
About the service
Adina Home Care Services is a domiciliary care service which provides personal care and support to people in their own homes. At the time of the inspection there were 154 people using the service. 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
The provider lacked oversight of the service. The provider was unaware of the issues identified during the inspection.
The provider did not consistently ensure that staff recruited were assessed as safe to work with people.
We were not assured that staff were provided with the necessary support and training to carry out their responsibilities effectively.
There were systems in place to ensure that medicines were managed appropriately. Daily records showed people had received their medicines as prescribed.
Systems were in place to ensure people and staff remained safe and protected from the spread of infection. There were policies on infection prevention and control and COVID-19 which were in line with national guidance.
People’s communication needs were not consistently met. Some people felt a sense of disempowerment because some care workers did not communicate clearly in English.
We received variable feedback regarding whether people were listened to when they complained. Some people felt their concerns and complaints had not been appropriately addressed.
Risks to people's safety were assessed and plans put in place to minimise risk of harm and to provide safe support. Environmental and health and safety risk assessments had also been carried out.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People were protected from the risk of harm and abuse. There were policies covering adult safeguarding, which were accessible to all staff. They outlined clearly who to go to for further guidance.
People were protected from the risks associated with poor infection control because the service had processes in place to reduce the risk of infection and cross contamination.
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 22 August 2018).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement and Recommendations
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 and will take further action if needed.
We have identified breaches in relation to recruitment, staff support and training and a lack of an effective quality assurance system.
We made two recommendations on complaints handling and accessible communication.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.