Archived: Eagle Care

Updated 26 June 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection was prompted in part by notification of an incident following which a person using the service died. This incident is subject to a criminal investigation and as a result this inspection did not examine the circumstances of the incident.

However, the information shared with CQC about the incident indicated potential concerns about the management of risk. This inspection examined those risks see list below.

Risk Assessments

Staff scheduling and time management

Accident and incident management

Staff training

On call support

Management oversight

Inspection team: This inspection was carried out by three inspectors.

Service and service type: Eagle care is a domiciliary care agency that was providing personal care to older and younger adults living in their own houses. At the time of the inspection on 17 April 2019 there were 10 people using the service. On our second visit on 2 May 2019 there were 0 people using the service.

The service did not have a manager registered with the Care Quality Commission (CQC). Having a registered manager means they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. A manager had been appointed and had applied to register with CQC.

Notice of inspection: This was an unannounced inspection.

We visited the office location on 17 April and 2 May 2019 to see the provider and the manager; and to review care records, policies and procedures. On 17 April 2019 we visited people in their houses. On 24 April 2019 we spoke with staff.

What we did:

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The provider returned the PIR and we took this into account when we made judgements in this report. We reviewed other information that we held about the service such as notifications. These are events that happen in the service that the provider is required to tell us about. We contacted Healthwatch Leicestershire. Healthwatch is an independent consumer champion created to gather and represent the views of the public. Healthwatch plays a role at both national and local level and makes sure that the views of the public and people who use services are considered. We also contacted the local authority safeguarding team and the local authority quality monitoring team for feedback.

During the inspection we spoke with two people who use the service and three relatives. We had discussions with five staff members including the manager, provider and three care and support staff.

We looked at the care and medication records of five people who used the service. We also examined records in relation to the management of the service such as staff recruitment files, staff training and supervision records, safe guarding information and accidents and incident information.

Following inspection, we requested and received:

Staff Handbook

Latest version of interview notes

Internal investigation report for a specific incident

Following inspection, we requested but did not receive:

Service user guide

Evidence of Mandatory training as per internal policy

Evidence of training booked to address any back log

Evidence of staff induction

Updated 26 June 2019

About the service: Eagle care is a domiciliary care agency that was providing personal care to older and younger adults living in their own houses at the time of the inspection.

People’s experience of using this service:

Risks to people had not been fully assessed. We found missing information and errors in recording.

Medicines were not managed safely, and people could not be assured that they would receive their medicines in line with their prescription.

Recruitment checks were inconsistent, this meant the provider could not be sure staff were fit for the role.

Accidents and incidents had not been managed in line with company policy and procedure. A serious incident highlighted failure in the management of accidents and incidents. There was limited evidence in learning when things had gone wrong. The manager understood their responsibility regarding safeguarding and reporting concerns.

There was inconsistency in staff training and induction. The lack of training schedules and training certificates meant that the provider did not have oversight of when training renewals were due.

One person had not been cared for or well supported during a serious incident. Other people told us staff were kind and caring and their dignity was respected and maintained. Personal information was stored securely.

Staff were often late, this had not been well managed by the provider who had failed to monitor time keeping and attendance of staff effectively. People were not consulted on changes in their visit schedule.

The provider had not maintained oversight of the safety and quality of the service. During the inspection on 2 May 2019 the provider informed us there was no governance structure in place to support the service and they were exploring outsourcing this support.

People had been involved in the planning of their care and support and their choices were supported. However, they were not asked for feedback on their satisfaction of the service. Information could be made available in different formats where needed such as large print or easy read.

People told us their complaints or concerns were responded to. One person found the provider approachable and was confident that if they raised concerns they would be dealt with. The provider had not logged or monitored complaints for patterns in line with internal policy and procedure.

Staff had access to personal protective equipment (PPE) to prevent the spread of infection. People told us they felt safe with staff.

Rating at last inspection: This was a new service that had not yet been rated.

Why we inspected: This was a first inspection brought forward due to information of risk.

Enforcement: The provider was in breach of five regulations of the Health and Social Care Act 2008 (Regulated activities) Regulations 2014 and one regulation of Care Quality Commission (Registration) Regulations 2009.

The overall rating for this service is ‘Inadequate’ and the service is therefore in special measures. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their 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.

Follow up: The provider cancelled their registration, therefore will not continue to carry out regulated activity.

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