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iCare Solutions Manchester Limited Requires improvement

This service was previously registered at a different address - see old profile

We are carrying out a review of quality at iCare Solutions Manchester Limited. We will publish a report when our review is complete. Find out more about our inspection reports.


Inspection carried out on 6 November 2019

During a routine inspection

About the service:

ICare Solutions Manchester Limited is a large domiciliary care agency. The service provides care and support to primarily older adults living in their own homes in the Trafford and Manchester areas of Greater Manchester. ICare Solutions Manchester Limited also provides care and support for people referred to the Stabilise and Make Safe (SAMS) service, contracted by the local authority. This service focuses on helping people regain their confidence, strength and independence following an illness, accident or hospital stay.

At the time of this inspection the service was providing care and support to 112 people. The Care Quality Commission (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:

The provider monitored staff timeliness through electronic call monitoring, although usage of this by staff was not consistent. Where this was used electronic call monitoring records indicated that many calls were cut short and people did not receive their commissioned support in full. People told us care staff were sometimes late and they were not always informed by the office.

There were processes in place to monitor and audit the safety of the service, although these had not identified some of the issues we found with records and there were inconsistencies with the supervision and appraisal of staff. The provider could evidence actions taken and ‘lessons learned’ when things had gone wrong.

People were receiving their medicines as prescribed. Improvements to assist with the recording and auditing of medicines were being introduced by the provider. People felt the staff providing support were competent. Staff were satisfied with the standard of training they received however, there was a lack of consistency with regards to supervision and appraisal of staff.

Most people were satisfied with the service they received. People were usually supported by consistent teams of staff who knew them and understood their needs and preferences. During our home visits we spoke with people who confirmed their regular staff were kind, respectful and aware of their specific needs. Recruitment processes had improved with a robust risk assessment of potential new employees where this was warranted.

There was information recorded in care plans about people’s social histories and people’s preferences. Care staff told us they would speak to the person and get to know them so that care was person-centred and met people’s needs. People received an annual quality assurance visit and review of their service, and the provider sought feedback about the service. People told us they felt involved in decisions about their care.

The registered manager was supported by a quality assurance officer, office-based care co-ordinators and administration staff. A new manager had been appointed days prior to this inspection with the intention of becoming the registered manager. The current registered manager planned to assume a regional role in the company.

Rating at last inspection:

We last inspected this service on 5 and 7 September 2018, when we rated the service requires improvement. The report was published on 30 November 2018. This is the fourth consecutive time the service has been rated requires improvement.

Why we inspected:

This was a planned comprehensive inspection to follow-up our last inspection when we rated the service requires improvement. Following our last inspection, we asked the provider to complete an action plan telling us how they would become compliant with the three breaches of regulations we identified relating to good governance, person-centred care and requirement as to display of performance assessments.


We are considering options in relation to enforcement action. Full information about CQC’s regulatory response to the mor

Inspection carried out on 5 September 2018

During a routine inspection

This inspection took place on 5, 6 and 7 September 2018 with the inspection being announced as we needed to give the provider notice. The inspection was carried out by one adult social care inspector and an expert by experience. On 6 September 2018 we made calls to people who use the service and staff to gain their views and experiences of the service.

ICare Solutions – Manchester is a domiciliary care service which provides personal care and support to people in their own homes to help them remain independent. They provide other elements of support such as sit-in services, domestic support and welfare checks. The service is managed from an office in Trafford, Greater Manchester with care and support provided for people living in the immediate area and other districts within Greater Manchester, including Stockport, Salford and Irlam. The length of visits for care and support vary depending on the assessed needs of people. At the time of this inspection 321 people were in receipt of a service and the company employed 201 community staff and 11 office staff. However, not everyone using the service receives 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.

At the time of this inspection there was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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.

This was the first inspection of this service at this location. Our last inspection of this service had been at a previous address and was carried out in December 2016, where we rated the service overall as Requires Improvement. At the last inspection we identified breaches of Regulation 11 and Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because staff did not understand or receive training in the Mental Capacity Act 2005 and the governance of the service required improvement.

The agency had moved to larger premises in August 2017 and had grown the business in size, providing care and support in the four areas of Greater Manchester. The areas of Salford and Stockport were kept separate from the main business of Manchester and Trafford, with each having an assigned care manager or co-ordinator to oversee the day to day basis, with oversight of all from the registered manager.

Recruitment processes were not always safe. Appropriate checks on staff had been undertaken however these checks had not always been carried out before staff began working for the service. Risk assessments completed when Data and Barring (DBS) checks identified staff with any previous convictions were not fit for purpose. Staff using the electronic call monitoring system correctly provided evidence that personal care calls had actually occurred but this was not being used by all staff. Medicines were sometimes stored in a locked tin and accessed only by care staff, therefore people were kept safe from the harmful effects of too many medicines. Staff received training on how to recognise abuse and understood what action was required if they should encounter it.

The registered manager used the interview process to ensure staff had the right skills, knowledge and experience to do the role. Training records showed staff had undertaken training in the Mental Capacity Act 2005 (MCA) and the service understood their responsibilities in how to implement this should someone not have capacity. Care plans reflected contact with health and social care professionals involved in people’s care if any health or support needs changed. People r