Kells Domiciliary Care Ltd

Kells Domiciliary Care Ltd is a domiciliary care agency providing the regulated activity of personal care to people living in their own homes. At the time of the inspection the service was supporting four 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 service had implemented the required improvements since the last inspection.

Recruitment checks were complete and adequately assessed staff suitability to work with vulnerable adults.

People received their medicines safely and as prescribed by care staff who had been trained and assessed as competent to administer medicines.

Risk assessments and management plans had been compiled to ensure people were supported to remain safe and free from harm. However, the service had not always fully assessed and recorded certain specific individualised risks associated with people’s health and medical needs. This was addressed immediately following the inspection.

One person and relatives told us they felt safe and confident with the care and support that they received from their care worker. Care staff had received training on how to recognise abuse and the processes to follow to report their concerns.

Care staff had access to the required personal protective equipment (PPE), information and guidance to prevent and control the spread of infection.

One person and relatives spoke positively about the management of the service, the quality of care delivery and the registered manager who they found to be responsive and accommodating.

Care staff felt supported and valued in their role.

The overall management oversight of the service had improved since the last inspection. The nominated individual and the registered manager had implemented audits and checks to monitor the quality of care and ensure where issues were identified these were addressed.

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 17 May 2019). There was a breach of regulation 17 (Good Governance) and two recommendations relating to staff recruitment and medicines management. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

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 of Safe and Well-led which contain those requirements and recommendations.

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 has changed from requires improvement to good. 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 Kells Domiciliary Care Ltd on our website at www.cqc.org.uk.

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.

Not everyone using the service receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

People’s experience of using this service:

People and relatives told us they felt safe with the staff and the support they received. People were safeguarded against the risks of abuse and harm.

Risk assessments were in place; however, these were not personalised. There was a lack of detailed guidance for staff to follow on how to keep people safe.

Medicines were not always managed safely. Records we checked did not give assurance that people received their medicines as prescribed. We have made a recommendation about this in our report.

Recruitment procedures had not been consistently followed. We have a made a recommendation about this in our report.

Audit systems in place to monitor the quality of care people received were not effective and did not identify the concerns we found at this inspection.

The registered manager assessed people's needs to help ensure they received appropriate care. Care plans were developed in partnership with people.

People and relatives told us staff were able to meet their needs and were respectful of their individual preferences. People said staff who supported them were kind and caring.

People and relatives confirmed the service did not miss any care calls and that staff were on time.

People received care and support from a small group of staff, which provided consistency.

We identified a breach of the Health and Social Care Act (Regulated Activities) Regulations 2014 around the governance of the service. Details of action we have asked the provider to take can be found at the end of this report.

Rating at last inspection:

This was the first inspection of the service since their registration with the CQC on 28 September 2018, following a change in provider.

Why we inspected:

This was a planned inspection based on the date of registration. Newly registered services receive an inspection within 12 months of the registration.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk