Archived: Curae Home Care

Updated 24 October 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

Two inspectors completed this responsive inspection.

Service and service type: Domiciliary care agency

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

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 beginning of the inspection 22 people were receiving support from the service.

The service is not required to have a manager registered with the Care Quality Commission. This is because the provider is registered as an individual and is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

The inspection was announced as we wanted to ensure someone would be available to assist us during the office visit. On arrival on the first day of the inspection despite this announcement we found that the office was closed and no staff were available to facilitate the inspection process. On both subsequent days of the inspection the provider failed to meet inspectors at agreed times.

What we did before the inspection:

We reviewed the records we held on the service. This included reviewing notifications. Notifications are specific events registered people have to tell us about by law. We also reviewed details of a number of safety concerns about the service’s performance that had been received by CQC and Cornwall Council’s safeguarding team.

During the inspection:

As we were unable to access the service’s office on the first day of our inspection we spent time speaking with people and staff via telephone. In total we spoke with nine people, three relatives and six members about the service’s performance.

On the second and third days of the inspection we spoke with an additional member of staff, the deputy manager and the provider. We inspected five people’s care plan and four staff recruitment files. We also reviewed the service’s; call monitoring data, daily care records and policy documentation.

After the inspection

We reviewed documentation gathered during the inspection process and contacted the provider to seek clarification on the measures they intended to introduce to urgently improve the service’s performance.

Updated 24 October 2019

About the service: Curae Home Care is a domiciliary care agency. It provides personal care to older people living in their own homes in the community. At the time of our inspection the service was supporting 22 people.

Rating at last inspection:

The last rating for this service was good (published 23 October 2019).

Why we inspected:

Prior to this inspection the CQC and Cornwall council’s safeguarding team received significant information of concern about the service’s performance. This included; reports of people’s visits being missed and late, reports of staff being employed without Disclosure and Barring Service checks being completed and concerns about the providers performance.

People’s experience of using this service:

We found the service was short staffed and there had been significant management changes since our last inspection. Both of the service’s senior staff were on maternity leave and a new deputy manager had been appointed. However, both the provider and the deputy manager were routinely completing care visits as the service did not have enough staff available to provide all planned care visits.

People and staff reported there had been a recent decline in the service’s performance and that planned visits had been missed, late and completed by insufficient numbers of staff. People’s comments included, “Until recently they always turned up. We have had quite a few problems. It is not the carers it is the management” and “[The staff)] are a really good team, but the management is beyond shocking.” Care plans and risk assessments showed people required support to access their medicines, manage their continence and to be repositioned to reduce risks of skin break down. Missed visits exposed people to risk of harm. It was specifically reported that the provider had failed to attend visits and staff told us, “I am not aware of any missed visits, other than the ones by the provider.”

The service did not have systems in place to record details of missed visits, investigate why visits had been missed or to try to identify learning where things had gone wrong.

In addition, we found the provider had routinely failed to complete records detailing the care and support they had provided. This included failures to record details of support with medicines. People were exposed to risk as it was not possible to establish what care had been given by the provider.

The service’s recruitment processes were unsafe. Necessary checks had not been completed to ensure prospective staff were suitable for employment in the care sector.

The provider was disorganised and unreliable. They did not give effective leadership to the staff team and their poor practice did not encourage staff performance. The provider failed to meet inspectors at agreed times on each of the three inspection days.

The CQC had significant concerns about the service, we wrote to the provider on the last day of our inspection requesting an action plan detailing what steps the provider intended to take to ensure people safety. The provider failed to respond to this request within the set timescales.

Enforcement: We found breaches of regulation. Full information about CQC’s regulatory response to the more serious concerns found in inspections and appeals is added to reports after any representations and appeals have been concluded.

Follow up: The overall rating for this service is ‘Inadequate’ and the service is therefore 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.

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