Inna Care

About the service

Inna care is a domiciliary care agency located in the London Borough of Havering. It is registered to provide personal care to people in their own homes. At the time of the inspection, 30 people were receiving support from the service. Most people using the service were older people, but there were at least 3 people with learning disabilities; all were receiving personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where people do receive personal care, we also consider any wider social care provided.

People’s experience of using this service and what we found

Right Support

Call planning and monitoring had improved since our last inspection. However, people and relatives told us more improvement could be made.

Recruitment processes were robust; the provider made checks on employees to ensure people’s safety. People were safeguarded from risk of abuse. The provider and systems and processes designed to support people safely.

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’s consent was sought before care was provided.

People were supported to eat and drink healthily. People were encouraged to remain independent and their privacy and dignity respected. People received personalised care and their needs were recorded in care plans. People were supported to take part in activities they enjoyed.

Right Care

People’s risks were assessed and monitored. Medicines were managed safely. Infection prevention and control measures were in place. People’s needs were assessed before they began using the service. Staff were received an induction before starting work, so that they knew how to do their job. This was followed up by further training. People and relatives told us staff were kind and caring. People were able to be involved in decisions about their care. People’s communication needs were met.

Right Culture

Lessons were learned when things went wrong; incidents and accidents were recorded and follow up actions completed to keep people safe. Staff were supervised and received appraisals to embed good working practices and provide the opportunity for development. Staff worked with other agencies to ensure people received good care.

People’s equality and diversity needs were recorded and people were supported in a culturally sensitive way. People were able to raise concerns and make complaints which the provider responded to appropriately. The service promoted a person centred approach and people and relatives were complimentary about the care. Quality assurance processes ensure good quality care.

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 requires improvement (published 30 December 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made, however the provider was still in breach of one regulation.

The last rating for this service was requires improvement (published 24 October 2019). The service remains rated requires improvement. This service has been rated requires improvement for one consecutive inspections.

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support right care right culture. This inspection was prompted by a review of the information we held about this service.

Enforcement. We have identified breaches in relation to staffing at this inspection.

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 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.

Inna care is a domiciliary care agency located in the London Borough of Havering. It is registered to provide personal care to people in their own homes. At the time of the inspection, 39 people were receiving support with personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where people do receive personal care, we also consider any wider social care provided.

People’s experience of using this service and what we found

This service was poorly organised. Staff time keeping was poor, this was due to poor call planning. Recruitment processes were not robust; application forms and interview notes lacked information such as their full employment histories. Infection control practice did not follow government guidance. Risks to people were not always recorded or monitored. Incidents and accidents were not recorded as per the provider’s policies, though we saw evidence of actions taken in an attempt to keep people safe.

People’s needs were not always assessed before they began using the service. People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. The provider was not seeking people’s consent before providing them with care. Staff did not always receive an induction before starting employment.

Records of staff training and supervision were not up to date when we initially inspected the service; the provider sent us updated records following the inspection. People’s dietary needs were not always recorded in their care plans.

The service was not providing a positive person-centred culture. Quality assurance measures were not effective, and the provider did not always address concerns we highlighted, such as things which could improve call monitoring. The service’s transfer from paper to digital systems had left gaps in their service as it was not planned effectively.

People’s healthcare needs were found in referral paperwork. Staff worked with other agencies to support people to received effective timely care. There was a safeguarding policy for staff to follow and people told us they felt safe receiving care. There were spot checks being completed with service users and feedback from people was being gathered.

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

Rating at last inspection

The previous rating for this service was good (published 25 May 2019).

Why we inspected

We received concerns in relation to staffing at the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We expanded our focus to the key question of effective during the inspection as we found concerns relating to assessing people’s needs and staff induction.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Inna 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 and will take further action if needed.

We have identified breaches in relation to staffing, fit and proper persons employed, safe care and treatment, person centred care, consent and good governance at this inspection.

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.

Innacare is a domiciliary care agency that currently provides personal care to four people.

People’s experience of using this service

Staff at the service knew what to do if they suspected abuse, however not all staff had been trained in safeguarding by the service. Risk assessments and risk management plans were completed to mitigate risks towards people. There were robust recruitment practices in place. Medicines were managed safely. Staff understood the need to prevent and control infection. The service learned lessons when things went wrong.

People were assessed to ensure the service could meet their needs. Staff received induction, training and supervision. Staff completed daily notes sharing relevant information about people. People were supported with their healthcare needs. People were supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible; the policies and systems in the service did support this practice.

People told us they were well treated. The service sought to protect people’s human rights. People were able to express their views and make decisions about their care. People’s privacy and dignity was respected and their independence encouraged.

People’s care plans were personalised and provided instructions to carers as to how people wanted their care. People and their relatives knew how to make complaints. There were advanced care plans in place to capture people’s end of life decisions.

People thought highly of the registered manager. There was guidance in place to support people and staff. The service had links with other agencies to benefit people who used the service. There were systems and processes in place to monitor and assure quality in care. Staff attended meetings where people’s care and other topics were discussed. We have made a recommendation about recording meetings.

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

Rating at last inspection

This service had not previously been inspected as it was a new service having been registered in February 2018.

Why we inspected

This was a planned inspection that was part of our inspection schedule. We inspected the service because it was under a new registration.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.