We carried out a review of the data available to us about Intercare Services Direct Ltd on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Intercare Services Direct Ltd, you can give feedback on this service.
Intercare Services Direct Ltd is a domiciliary care service providing personal care to adults living in their own homes. At the time of our inspection there were 65 people using the service.
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
The provider had improved quality management systems to ensure issues were identified quickly and appropriate actions taken. The registered manager had several systems in place to gain people’s feedback and ensured they used suggestions and ideas to improve the service.
Professionals working with the provider were complimentary and felt Intercare Services Direct Limited, were a caring provider.
Risks associated with people's care were identified and actions were taken to mitigate risks. The provider had a safeguarding procedure in place and staff knew what actions to take to safeguard people from the risk of abuse. Staff were recruited safely, and pre-employments checks were carried out to ensure suitable staff were employed. Medicines were managed safely.
Staff received training and competency checks to ensure they had the skills and were competent to administer medicines safely. The provider was taking appropriate action to ensure infection control was monitored safely. PPE was available to use as required. There were systems in place to ensure lessons were learned when things went wrong.
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.
People's needs were assessed, and care delivered in line with them. Care packages were reviewed regularly to ensure people's current needs were reflected.
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 18 February 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and leadership.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
This was an ‘inspection using remote technology.’ This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and video and phone calls to engage with people using the service as part of this performance review and assessment.
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.
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 140 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
The registered provider had effective recruitment procedures in place to make sure staff had the required skills and were of suitable character and background. There were enough staff available to ensure people’s care and support needs were met in a timely way. Where people needed support with managing their medicines there were systems in place to ensure people received their medicines as prescribed.
Staff were provided with an effective induction and relevant training to make sure they had the right skills and knowledge for their role. Staff were supported in their jobs.
Staff understood the requirements of the Mental Capacity Act 2005. 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.
People told us staff were kind and caring. Staff knew how to treat people with dignity and respect.
People’s care and support was planned and delivered in a way that ensured it met their needs and reflected their preferences.
The service had up to date policies and procedures which reflected current legislation and good practice guidance. There were effective systems in place to monitor and improve the quality of the service provided.
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 2 October 2017). Since this rating the service has moved premises. We have used the previous rating to inform our planning and decisions about the rating at this inspection.
Why we inspected
This was a planned inspection based on the previous rating.
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.