Careville Limited

Updated 3 June 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 houses and flats.

The service had a manager registered with the Care Quality Commission. This means that they 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 announced. We gave the service 72 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 26 April 2021 and ended on 5 May 2021. We visited the office location on 26 April 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. We looked at all the information which we hold about the service including notifications. This information helps support our inspections. We used all this information to help plan our 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.

During the inspection

We spoke with one relative about their experience of the care provided. We spoke with four members of staff including the registered manager and care staff.

We reviewed a range of records. This included one person’s care records and 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 policies and procedures were reviewed.

Updated 3 June 2021

About the service

Careville Limited is a domiciliary care agency providing personal care to people living in their own homes or flats. At the time of the inspection, the service provided support to two people.

Not everyone who used the service received 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

People were not supported in a consistently safe manner. Risk assessments did not provide clear guidance for staff to reduce identified risks. The registered manager had supplied an action plan after the previous inspection. However they had failed to make the necessary improvements to ensure that care was delivered in a safe and effective manner.

Medication administration records (MAR) and daily records were not always completed accurately. This meant it was not clear if people had received the required level of care to keep them safe.

Staff pre-employment checks had not been completed. This meant the provider had not checked staff suitability to support people. This was an area requiring improvement which the provider had previously been told to take action but had failed to do so.

There was a lack of provider oversight and management at the service. The registered manager had failed to recognise their responsibility to ensure the delivery of care was of a high quality and safe. The quality assurance processes in place were not robust and did not drive improvements in the service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; however the policies and systems in the service did not support this practice. Care records did not clearly detail if people had capacity or how staff should support them in making decisions.

Staff had received COVID-19 training. Relatives told us they felt assured by staff who were observed wearing appropriate personal protective equipment (PPE). This included facemasks, gloves, aprons and face visors.

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 8 August 2019) 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. This service has been rated as requires improvement for the last two consecutive inspections.

At this inspection we found the provider had not made improvements and was still in breach of regulation.

Why we inspected

We carried out an announced comprehensive inspection of this service on 20 June 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve management of safety risks and recruitment processes.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe, effective and well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service remains Requires Improvement. 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 Careville 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 safe care and treatment; fit and proper persons employed and good governance.

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.