Background to this inspection
Updated
29 April 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
The inspection team consisted of two inspectors
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service did not have a manager registered with the Care Quality Commission although the nominated individual had applied to register as the manager of the service. The nominated individual is responsible for supervising the management of the service on behalf of the provider. As the company was in liquidation the provider was an administrator for the company. This means they were legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or senior staff would be in the office to support the inspection.
Inspection activity started on 23 March 2021 and ended on 25 March 2021. We visited the office location on 25 March 2021.
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 all the information we held about the service prior to our inspection, this including any information shared with us by members of the public and other stakeholders.
We used all this information to plan our inspection.
During the inspection
We spoke with eight relatives and friends of people who used the service about their experience of the care provided. We also spoke a social worker and six members of staff including the nominated individual, senior care workers and care workers.
We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including training data and quality assurance records were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
29 April 2021
About the service
We Always Care Ltd is a domiciliary care service providing personal care to people aged 65 and over. At the time of our inspection the service was supporting seven people.
Not everyone who used the service may receive 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
Management oversight of the service needed further improvement. Whilst the provider had introduced some systems to check the quality of the service provided since our last inspection, further improvements were required for the monitoring of the service and staff support systems. There was no registered manager in post at the time of our inspection.
People’s relatives and friends told us they were protected from risks to their safety. People were supported by staff who knew when to report concerns and managed any identified risks. People were supported to receive their medicines as prescribed and quality assurance tools in place supported this process.
People were supported by sufficient staff who had been safely recruited.
People’s relatives were satisfied with the care people received. People's care records had improved since the introduction of a new electronic recording system and now showed actions staff took to provide effective care.
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 requires improvement (published 11 October 2019). There were multiple breaches of regulation in relation to the safe administration of medicines, staff recruitment and governance. The provider completed an action plan after our last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made to systems for management of medicines and staff recruitment. However, despite some improvement in governance the provider remained in breach of Regulation 17 HSCA RA Regulations 2014 (good governance). The service remains rated requires improvement. The service has now been rated as requires improvement for two inspections.
Why we inspected
We received concerns in relation to staffing and governance. 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 remained unchanged. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvement. Please see the well led section of this full report. You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for We Always Care 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 have identified a continued breach in relation to good governance at this inspection. Please see the action we have told the provider to take at the end of this report.
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.