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Intercare Services Direct Ltd Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 19 February 2021

About the service

Intercare Services Direct Ltd is a domiciliary care service which provides personal care to adults with a range of support needs in their own homes. At the time of this inspection the service was supporting 142 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

At the time of inspection. the service was being managed by the provider’s head of operations and they had applied to register with the CQC.

People and relatives spoken with did not share any concerns about people’s safety. We received mixed views about the quality of care provided. Some people and relatives were satisfied with the quality of care provided and made positive comments about the care staff. However, some people and relatives raised concerns about the lack of continuity of care. The head of operations told us during the pandemic it had been even more difficult to ensure people received good continuity of care due to seriously low staff levels at time, often at short notice.

The assessment of people’s individual potential risks and/or the measures in place to reduce and manage the risks to the person required improvement. The proper and safe management of medicines required improvement to ensure people received medicines at the right time and/or for best effect. Safeguarding procedures were robust and staff understood how to safeguard people. Care staff told us office staff responded to their calls for assistance promptly. A new accident and incident procedure had been introduced at the service and this was being embedded into service practice.

The provider had completed pre-employment checks for new staff, to check they were suitable to work at the service. Care staff told us the service had been short staffed during the pandemic. They told us they had been asked to complete additional calls as there were not enough staff to cover unexpected absence. The head of operations told us that care coordinators and managers have made every effort to keep rotas to as close to the originals as planned. However, last minute changes to rotas have been necessary to ensure service delivery was met during periods of being short staffed.

We found concerns about some people's care plans and risk assessments. For example, we found some people did not have risk assessments and/or care plans in place for specific health care conditions. Two of the care plans we looked at contained significant contradictions. Although we did not find this had negatively impacted on people using the service; there was increased risk people would not receive appropriate care and achieve good outcomes

Most staff felt supported. The system in place to ensure all staff received regular one to one sessions required improvement. Staff received a range of training and support relevant to their role. Some staff told us they had not received some relevant specialist training or it had been of a poor quality. We shared this feedback with the head of operations.

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; the policies and systems in the service supported this practice.

The provider had systems in place to engage and involve people using the service and their representatives. However, relatives and people shared concerns about the poor response to their calls to the office. Staff did not always ring back as promised. This showed there were missed opportunities to continue to learn and improve service delivery.

Our findings during the inspection showed the systems in place to assess, monitor and mitigate the risks relating to the health and safety of people was not effective in practice.

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 was Good (published 31 January 2020).

Why we inspected

The focussed inspection was prompted in part by notification of a specific incident. This incident was being investigated by the local safeguarding authority. This inspection did not examine the circumstances of the incident. The information CQC received indicated concerns about the safe care and treatment of people, particularly in relation to risk management. This inspection examined those risks. We undertook a focussed inspection to review the key questions, safe, effective 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 requires improvement. This is based on the findings at this inspection.

We found evidence the provider needs to make improvement. Please see the safe, effective and well-led sections of the 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 Intercare Services Direct Ltd on our website at www.cqc.org.uk.

Enforcement

We identified breaches in relation to the management of people's risks, records and quality assurance.

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.

Please see the action we have told the provider to take at the end of this report.

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.

Inspection areas

Safe

Requires improvement

Updated 19 February 2021

The service was not always safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 19 February 2021

The service was not always effective.

Details are in our effective findings below.

Caring

Good

Updated 19 February 2021

Responsive

Good

Updated 19 February 2021

Well-led

Requires improvement

Updated 19 February 2021

The service was not always well-led.

Details are in our well-Led findings below.