CareArt UK

CareArt is a domiciliary care agency providing the regulated activity of personal care to people living in their own homes. The service provides support to older people who may be frail or who have a health condition. 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. At the time of inspection, the service was providing care to 6 people.

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

People and staff had seen improvements to the service since our last inspection. People received their care calls when they were expecting them and told us staff stayed the full time. Staff told us they had more time to spend with people now and did not feel rushed.

People received the medicines they required from appropriately trained staff. Staff were undertaking additional training to help ensure they were competent in their role.

People were cared for by staff who knew them well, consistently carried out their care calls and treated them with respect and dignity. People were supported to retain their independence and make their own decisions about their care.

People felt safe with staff and staff knew how to report any concerns they may have. Risks identified for people had been recorded and information was in place to help staff provide care in a way that reduced people’s risks.

People received a service that resulted in good outcomes for them. This included staff supporting people with their food and drink as well as accessing healthcare professional input when required.

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.

New systems and processes had been introduced to the service to help the registered manager monitor the quality of care. This had given them a better understanding of their role and responsibility as a registered person, although it was going to take more time for these methods to be embedded sufficiently.

People and staff were asked for their views through surveys, meetings and spot checks.

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 the service was Inadequate. Report published 15 November 2022. Since that inspection, the provider has changed the name of the service and moved address.

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 improvements had been made and the provider was no longer in breach of regulations.

At our last inspection we recommended that the registered provider reviewed their training for staff. At this inspection we found the registered manager had acted on our recommendation.

This service has been in Special Measures since 15 November 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was prompted by a review of the information we held about this service and to check whether the Warning Notice we previously served in relation to Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Missions Healthcare Services LTD is a domiciliary care agency providing personal care. The service provides support to older people and those with dementia. At the time of our inspection there were nine people using 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

Risks to people were not always managed safely, with a lack of guidance to support staff in mitigating risks to people. Call records identified that staff were late for calls and did not always have enough time between calls; impacting on their ability to stay the duration. Medicines were not safely administered with conflicting guidance for staff.

Safeguarding concerns were not reported in a timely manner. The registered manager did not ensure there was sufficient investigation of incidents and accidents.

Staff did not always receive sufficient support to help them carry out their roles, with a lack of regular supervision. Multiple training topics were addressed across two days, which means we were not assured staff had enough time to develop their learning. Staff did not ensure that presenting healthcare needs were highlighted in a timely manner.

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.

Care plans were not as personalised as they should be. Complaints records were not available at the time of inspection.

The registered manager did not ensure that there was effective governance of the service, with a lack of audits and quality control systems. Timely action was not taken to address required areas of improvement.

Staff and the care they delivered was well thought of. Staff were safely recruited and we were assured that infection control processes were followed.

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 good (published 23 July 2021).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Missions Healthcare LTD on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, staffing and good governance at this inspection.

We have made recommendations in relation to safeguarding people from abuse and improper treatment, staff training and complaints.

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 and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

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.

About the service

CareArt UK is a domiciliary care agency providing personal and nursing care to 26 people aged 65 and over at the time of the inspection. 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

We have made a recommendation about the service’s risk management plans in relation to COVID-19.

People were protected against abuse, as staff received safeguarding training and were aware of the provider’s safeguarding policy. Risk management plans gave staff guidance on how to mitigate identified risks. People received their medicines as intended. People received care and support from staff that were appropriately vetted, and staff were deployed in a timely manner. Staff confirmed they had sufficient access to Personal Protective Equipment.

The provider carried out audits to drive improvements, the registered manager was keen to continuously improve and worked in partnership with other stakeholders. People were encouraged to share their views of the service.

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 Requires Improvement (published 25 July 2019). 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 improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

The inspection was prompted in part due to concerns received about the overall management of the service and infection control measures. As a result we undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for CareArt UK on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

CareArt UK provides personal care and support to people living in their own homes. At the time of the inspection there were six people receiving personal care from nine staff.

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

The registered manager had not consistently made sure staff were of good character and suitable to support vulnerable people in their own homes, to stay safe and meet their needs.The registered manager had not always obtained a full employment history, before new staff had begun to support people. Where staff had disclosed their previous employment with other care providers, the provider had not verified their reason for leaving.

The registered manager did not consistently operate quality assurance and governance systems to drive continuous improvement in the service.

Staff worked effectively in partnership with professionals to deliver care and support and developed links with the local community.

People experienced good quality care.People and their relatives consistently provided positive feedback about all aspects of the care they received.

People were protected from avoidable harm, and abuse by staff, who understood their role and responsibility in relation to safeguarding and keeping them safe.

People experienced care, delivered in accordance with their risk assessments and management plans.

The service deployed enough staff with the required skills and knowledge to meet people’s needs. Staff felt they were valued, respected and well supported by the registered manager.

Staff had developed meaningful, caring relationships with people, which respected their dignity and privacy, and promoted their independence. People’s care and support met their needs and reflected their preferences.

The provider upheld people’s human rights. 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.

People were actively involved in making decisions about their care.

The provider assessed and met people's individual communication needs and responded quickly when people's needs changed.

People experienced kind and compassionate care at the end of their life and were supported to have a comfortable, dignified and pain-free death.

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

Rating at last inspection:

This service was registered with us on 15 February 2018 and this was the first inspection.

Why we inspected:

This was a planned comprehensive inspection.

Enforcement:

We have identified two breaches of regulation at this inspection, in relation to the provider’s failure to consistently operate safe recruitment procedures and establish and effectively operate a system to assess, monitor and improve the quality and safety of the services provided. Please see the action we have told the provider to take at the end of this report.

Follow up:

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.