Archived: Infinite Care

Updated 24 January 2023

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 one inspector who visited the office location and reviewed evidence remotely using the provider’s online records systems. We used an Expert by Experience who made phone calls to people and their relatives. 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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. At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service a short period of notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 4 May 2022 and ended on 24 May 2022. We visited the location’s office on 4 May 2022.

What we did before inspection

We reviewed the safeguarding concern that triggered this inspection and any information we had received from the service since the last inspection. We sought feedback from the local authority. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with three people using the service and seven relatives about their experience of the care provided. We spoke with nine members of staff, including the director, nominated individual, registered manager and care staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records. This included 12 people's care records and multiple medication records.

We looked at all care staff files in relation to recruitment, training and supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed. We continued to seek clarification from the provider and registered manager to validate evidence found. We sought feedback from external professionals involved in the service.

Updated 24 January 2023

About the service

Infinite Care is a provider of community home care services. At the time of the inspection it was providing personal care to 23 people aged 65 and over. 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

People told us they felt they felt safe. However, we found significant concerns in safety and the management of the service which demonstrated people were not receiving safe care.

Information about risks in people’s care plans was not always effective and placed people at risk of harm. Written information detailing how people should be supported safely was not completed or had important missing information. The provider failed to protect people from abuse and to take action when abuse was suspected.

People were at risk of harm due to poor medicines management. There was a lack of information to ensure staff understood when to give medicines which were prescribed ‘as and when required’. We could not be sure people received their medicines safely, as prescribed or by staff that had been sufficiently trained to do so.

Staff had not always received training to equip them to support people, understand their individual needs and mitigate associated risks.

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. Due to the quality of the care records we could not be assured care had been provided in line with peoples assessed needs, wishes and choices.

The service was not well led. There was a lack of provider oversight and quality monitoring to identify and address risks to people. Auditing was not robust where concerns were raised at previous inspections. The provider failed to take action to sustain improvements.

The registered manager did not have enough autonomy and oversight of the service to ensure that it was being managed safely and quality care was provided.

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 11 November 2020) and there were breaches of regulation for failing to assess and mitigate risks to people, failing to work within the principles of the mental capacity act, failing to have effective systems in place to assess and monitor and failing to improve the safety of the service. The provider completed an action plan after the last inspection to show what they would do to improve. At this inspection we found the provider remained in breach of regulations.

At our last inspection we recommended that the provider update their infection control policy, improve systems to gain feedback from people using the service, improve recruitment processes and improve staff support with supervisions and training. At this inspection we found the provider had not sufficiently acted on these recommendations.

The service is now rated inadequate. This service has been rated inadequate or requires improvement for the last four consecutive inspections.

Why we inspected

This inspection was prompted by concerns we received about a safeguarding incident. A decision was made for us to carry out a focussed inspection and examine this incident, check if the provider had followed their action plan from the last inspection and to confirm if they now met legal requirements. As a result, we reviewed the key questions of safe, effective and well led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We found evidence during this inspection that people were at risk of harm and the provider needed to make improvements in all areas inspected. Please see the safe, effective and well led sections of this full report. The overall rating for the service has changed from requires improvement to inadequate based on the findings of 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 Infinite 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 safe care and treatment, consent, safeguarding, person centred care, staff support, training and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Since the last inspection we recognised the provider had failed to notify us of all significant events. This was a breach of regulation. Full information about CQC’s regulatory response to this is added to reports after any representations and appeals have been concluded.

Follow up

We worked alongside the provider and local authority to monitor progress. We continued to monitor information we received about the service.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service was therefore placed in ‘special measures’. We took action to cancel the provider’s registration through our enforcement process. This meant we have taken action to prevent the provider from operating this service. This has lead to cancellation of their registration.