Inmind community Support Services Limited

Updated 12 August 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 was carried out by one inspector and an assistant inspector.

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

This inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 16 June 2022 and ended on 22 June 2022. We visited the location’s office on 16 June 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with four people who used the service and three relatives about their experience of the care provided. We spoke with six members of staff including care workers, the registered manager, the head of quality and governance and a member of staff in charge of recruitment. We reviewed a range of records including four people’s care records and medication records. We looked at two staff files in relation to recruitment. We looked at a variety of records relating to the management of the service.

After the inspection

We continue to seek clarification from the provider to validate evidence found. We looked at staff records and quality assurance records.

Updated 12 August 2022

About the service

Inmind Community Support Services is a domiciliary care service providing personal care for people living in their own homes. At the time of the inspection 14 people were receiving personal care from the service.

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

Since our last inspection, a number of care and office staff had left at very short notice which resulted in the provider contacting the local authority to arrange for packages of care to be transferred to other care providers. Responsibility was left with the registered manager to fulfil the responsibilities of the vacant office posts. This resulted in a lack of effectiveness in the governance of the service as the registered manager took on additional duties to ensure people’s care needs were met.

Systems were not in place to effectively monitor call delivery times. This resulted in some people experiencing early, late or short calls. Care records did not always hold the most up to date information regarding people and their care needs. People and relatives raised concerns regarding poor communication with the service.

Staff felt supported by the registered manager but had not received regular supervision or had their competencies assessed for some time.

There was no evidence the provider had actively sought feedback from people who used the service to help them monitor and improve the quality and safety of the service, and make changes in response to people’s feedback.

People felt safe when supported by staff in their own home . They were supported by a consistent group of staff who had been recruited safely and were aware of their care needs.

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.

Staff were aware of the latest government guidance regarding infection prevention control and had access to plentiful supplies of personal protective equipment (PPE.)

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 26 July 2021).

Why we inspected

The inspection was prompted in part due to concerns received about staffing levels and the timings of calls. A decision was made for us to inspect and examine those risks.

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 Inmind Community Support Services Limited 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 good governance at this inspection.

At our last inspection of the service in June 2021, it was agreed the provider could apply to have the conditions on their registration removed, as enough improvement had been seen in the governance of the service. However, the provider continued to submit monthly reports and did not apply to remove those conditions. At this inspection, we were not assured regarding the effectiveness of the governance systems in place. We therefore advised the provider that a decision has been made to keep the conditions in place to obtain assurances that governance systems would be improved. The provider will continue to submit monthly reports to provide evidence of this.

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

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.