11 January 2023
During an inspection looking at part of the service
Sanctuary Life Care Limited is a domiciliary care service providing personal care to people in their own homes. These can be older people or younger adults living with a learning disability or autistic spectrum disorder, dementia, a physical disability, mental health or sensory impairment. At the time of the inspection one person received personal care.
Not everyone who uses the service may receive 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
This was a targeted inspection that considered management of risks and the quality and safety of the service within Safe and Well Led key questions. Based on our inspection of these areas, we found improvements were still required.
Audits systems continued not to be fully effective in identifying areas needing improvement to ensure the quality and safety of the service was maintained. The lack of robust governance had resulted in the failure to identify the issues that we found. We have made a recommendation about seeking additional guidance around regulatory requirements to help improve the governance of the service.
Risks associated with people’s needs were not always assessed to ensure staff had the information they needed to provide safe and consistent care. Accessibility to records to evidence care and safe practice continued to need improvement. There had been some improvement to medicine records to confirm how they were managed but further improvement was needed.
Staff recruitment information did not follow the providers recruitment policy to ensure staff were safe, and suitable, to work with people. Training records were not sufficient in detail to show staff were suitably trained to support people. Positive comments were received from a person using the service. Staff felt supported by the registered manager and deputy manager.
Following our feedback, the provider told us of action taken to address any immediate risks.
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 inadequate (published 3 November 2022). 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 the provider remained in breach of regulations.
Why we inspected
We undertook this targeted inspection to check whether the Warning Notice we previously served in relation to Regulation 12, 17 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. This related to specific concerns we had about access to records, policies and procedures not being followed, care planning, medicine management and recruitment practices. The overall rating for the service has not changed following this targeted inspection and remains inadequate.
We use targeted inspections to follow up on Warning Notices or to check concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
Enforcement and Recommendations
We have identified continued breaches in relation to Regulation 12 Safe care and treatment, Regulation 17 Good Governance and Regulation 19 Fit and proper persons employed, 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.
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 to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.