Archived: Divine Motions Healthcare Services Ltd

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.

Divine Motions Healthcare Services Ltd is a domiciliary care service that provides care and support to 83 people living in their own houses or flats in the community. 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

People’s care plans were not person centred and were task focused.

We have made a recommendation about person centred care planning.

We received some feedback about instances of staff lateness and timekeeping concerns particularly at the evening and weekends.

Medicines records contained unexplained gaps and lacked information in relation to topical creams and ‘as and when required’ (PRN) medicines.

Risk assessments lacked information in relation to managing risks to ensure people are safe.

There were systems in place to assess and monitor the quality of the service provided. However, were not sufficiently robust to identify that improvements were needed in relation to medicines, risk assessments, staff timekeeping, medicines management and care plans not being person centred.

People told us they felt safe using the service. Staff followed appropriate infection control practices. Accident and incidents were recorded and acted upon. Any lessons learnt were used as opportunities to improve the quality of service.

Assessments were carried out prior to people joining the service to ensure their needs could be met. Staff had the training, knowledge and experience to meet people's needs. People were supported to maintain good health and had access to a range of healthcare services when needed. People were supported with their food and drink.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

There were procedures in place to respond to complaints. The provider had investigated and responded promptly to any concerns received.

The provider worked in partnership with healthcare services and professionals to plan and deliver an effective 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 good (published 20 October 2018). Since this rating was awarded the provider has altered its legal entity. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

Why we inspected

This inspection was part of our routine scheduled plan of visiting services to check the safety and quality of the care people received.

Enforcement

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

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.