Background to this inspection
Updated
7 May 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.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
The service did not have a manager registered with the Care Quality Commission. A registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
Inspection activity started on 18 January 2021 and ended on 21 January 2021. We visited the office location on 21 January 2021.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and the local Healthwatch team. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. 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. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with two people who used the service and five relatives about their experience of the care provided. We spoke with seven members of staff including the care co-ordinator, the office assistant, and care assistants.
We reviewed a range of records. This included three people’s care records and medication records. We were provided with a staff matrix detailing training, recruitment checks and supervision. We reviewed a variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
7 May 2021
About the service
Huggies Cares Limited provides personal care to people living in their own homes in the community. Not everyone who used the service received personal care. Care Quality Commission (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 commencement of our inspection the service was providing personal care to 14 people. However, during the inspection period, this figure decreased as the local authority was in the process of removing packages of care due to concerns about the safety of the service.
People’s experience of using this service and what we found
The provider had not ensured people’s individual risks had been assessed and managed. There were no Covid-19 risk assessments and risk management plans in place for the service, staff and people who use the service. People’s medicines were not always managed safely.
The provider had not ensured people were protected from the risk of abuse. We raised two safeguarding alerts with the local authority during our inspection. People did not always receive their care visits on time, or the call was missed entirely, and this placed people at the risk of harm.
The provider had not ensured there was adequate and effective management oversight of the service. There was no manager is place and the service was being co-ordinated by someone who had no experience of care or management. There were no support mechanisms in place for this staff member. Records were out of date and there was no quality monitoring of the service. There had been no registered manager at the service since September 2020.
Staff were providing care to people in the community but had not been provided with suitable training, supervision and competency checks. Staff training was delivered by persons who were not qualified to do so.
Staff had not undergone the necessary, legal safety checks to ascertain their suitability to work with people who may be vulnerable. Staff were providing care to people in their own homes without first obtaining assurances of DBS checks and suitable references.
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 28 June 2019).
Why we inspected
We received complaints and whistle-blower concerns in relation to missed care visits, safe recruitment practice, staff training levels, medication errors, poor levels of care, safeguarding incidents and inadequate management of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to inadequate. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe 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.
We requested assurances from the provider to mitigate any risks to people; however, we were not reassured with their response.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Huggies Cares Limited 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 have identified breaches in relation to medicines safety, risk assessments, safeguarding people from abuse, missed care calls, safe recruitment practice, staff training and supervision and inadequate management and governance of the service.
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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
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.