Fairway Homecare Limited

Fairway Homecare Limited is a domiciliary care service providing personal care to people in their own homes. 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. The service is also registered to provide treatment of disease, disorder and injury although this was not being provided at the time of the inspection. At the time of our inspection 26 people were receiving personal care from the service.

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

People were not always protected from the risk of harm; we found systems were not effective in reducing risks to people that resulted from their health needs and the use of prescribed medications. Systems in place to safeguard people from abuse were not robust and processes for learning lessons were not established to drive improvements.

Quality assurance systems were not in place to ensure people received consistent, high-quality and safe care. Following our last inspection, the provider had not implemented the actions required to improve the safety and quality of the service people received. There continued to be a lack of oversight over people’s medicines, assessing people’s needs and the management of the service.

People did not always feel they were supported in a caring and compassionate way. People and relatives experienced inconsistencies in the caring, respectful approach of staff. However, people with regular staff spoke highly of their diligence. People experienced limited input into the design and review of their support.

People’s person-centred needs were not effectively identified and planned for by the service. This meant people sometimes experienced support that wasn’t in line with their needs and preferences.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; although the policies and systems in the service were in place to support good practice.

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 July 2019) and there were breaches of regulations. 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

The inspection was prompted in part due to concerns received about missed calls, the safety of care provided and the governance of the service. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe, responsive and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches in relation to how people’s safety was managed, how people were safeguarding from abuse, people’s person-centred needs and how the service was run at this inspection.

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

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 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.

People’s experience of using this service:

Systems around medicine management needed improving. You can see what action we told the provider to take at the back of the full report.

Care plans and risk assessments were not in place for all of people’s known risks. Where care needs had changed care plans and risk assessments had not always been updated to reflect people’s most current needs. This placed people at risk of receiving unsafe care.

Governance systems were either not in place or not robust. This meant that systems were not effective in monitoring the quality and safety of the service. You can see what action we told the provider to take at the back of the full report.

The provider took immediate action to begin to address the shortfalls identified through the inspection and has kept us updated on improvements that have been introduced.

Staff had received mandatory training although we found improvements were needed in providing specific training around people’s individual needs. Staff felt supported by the management of the service.

People felt cared for by the regular staff who supported them. Some relatives reported that people did not always receive regular staff and that had had an impact on their relatives care. People had been involved in planning and reviewing their care and were supported to have choice and control of their lives.

Rating at last inspection: This was the services first inspection at this location.

Why we inspected: This was a scheduled inspection

Follow up: We will continue to monitor the service and will inspect following our re-inspection programme. We may inspect sooner should we receive any concerning information.

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