Background to this inspection
Updated
10 July 2021
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 Care Act 2014.
Inspection team
This inspection was carried out by one inspector and two Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
The service had a manager registered with the CQC. This means they are legally responsible for how the service is run and for the quality and safety of the care provided. The service notified us that the registered manager was absent and the general manager of Divine Motions Healthcare Ltd was in charge of the service at the time of this inspection.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the general manager would be in the office to support the inspection.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and healthcare professionals who work with the service. We used all of this information to plan our inspection.
During the inspection
On 15 April 2021 we spoke by telephone with 25 people who used the service and 9 relatives about their experience of the care provision. We also spoke with one member of staff who provided care to people. We visited the providers office on 13 May 2021. We spoke in-person with the general manager and an office administrator. We received feedback from a Local Authority who commissioned services from Divine Motions Healthcare Ltd.
We looked at a range of paper and electronic records. This included five staff files in relation to their recruitment, staff supervision and training records, eight care plans, complaints log and a variety of other records relating to the overall management and governance of the service.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We requested the provider send us additional evidence after our inspection in relation to staff working rosters, staff recruitment, training and care planning.
Updated
10 July 2021
Divine Motions Healthcare Services Ltd is a domiciliary care agency. At the time of our inspection they were providing support with personal care to 55 people who lived at home.
People’s experience of using this service and what we found
At the last inspection we found the provider’s systems for the safe management of medicines, safe staffing and good governance were not effective. At this inspection we found the required improvements had not been made and the service remained in breach of the regulations.
People praised the regular care staff who supported them but felt the management of the service was not responsive with their issues / concerns not being heard or responded to. For example, in a comment typical of many, one person told us, “They are really nice carers, but it’s the organisation that lets it down. The office says they will ring back and then they don’t. It really upsets my routine and stresses me out. They really have to look at how the place is run”.
Some people did not consistently receive their care calls at the times as agreed for their package of care. The system to allocate calls was not effective and was inadequately monitored.
Medication management was not safe. Staff were not provided with full information regarding people’s medication and the risks associated with it. The systems in place could not provide assurances that people received their medication as prescribed.
The provider’s governance systems failed to identify and address a number of areas of concern that were found during this inspection. A lack of management oversight meant risks to people's safety were not being responded to in an appropriate and timely manner.
Rating at last inspection and update
The last rating for this service was requires improvement (published 23 January 2020) and there were multiple breaches of regulation. 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 required improvements had not been made and the provider was still in breach of regulations.
Why we inspected
We undertook a focused inspection to review the key questions of safe, responsive and well-led. The inspection was prompted in part due to concerns received about people’s calls being late or missed, people receiving unsafe care and a lack of effective management of the service. A decision was made for us to inspect and examine those risks.
The overall rating for the service has changed from Requires Improvement to Inadequate. 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 Divine Motions Healthcare Ltd 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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We identified there were continued breaches in relation to safe management of medicines, staffing and good governance. Please see the action we have told the provider to take at the end of this report.
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.