Background to this inspection
Updated
14 May 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 was carried out by two inspectors.
Service and service type
The service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
Notice of inspection
We gave the service short notice of the inspection. This was because it is a small service and we needed to be sure that the provider would be in the office to support the inspection.
Inspection activity started on 21 January 2021 and ended on 4 February 2021. Two inspectors visited the office location on 3 February 2021. One inspector returned to the office on 4 February 2021.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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 used all this information to plan our inspection.
During the inspection
We spoke with four people who used the service and five relatives about their experience of the care provided. We spoke with eight members of staff including the nominated individual, office manager, a senior care worker and five care workers. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with three health and social care professionals on the telephone about their experiences with the provider.
We reviewed a range of records. This included eight people’s care records We looked at four 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.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
14 May 2021
About the service
SA Quality Care is a domiciliary care agency providing personal care to people in their own flats and homes. The provider is commissioned by the local authority to provide STEP services. This is short term enhanced provision where the agency provides an initial six weeks period of care after which the support package is usually transferred to a longer-term provider. When we visited the office, we were told the service was supporting 20 people.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is to 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 always safe. Risks to people’s health and safety were not assessed or mitigated.
Medicines were not managed safely.
Safe recruitment practises were not followed as the required checks had not been undertaken before staff started work. Staff did not receive induction and training to support them effectively in carrying out their role.
Systems to assess, monitor and improve the service were not in place. Issues with recruitment, risk management and medicines which should have been prevented from occurring had not been identified by the provider. In some cases, there were no records of the care and support the service was providing to people.
People and relatives spoke positively about the service provided. They were satisfied with call times and said they were supported by the same staff. Although people told us they felt safe the absence of effective systems to identify and manage risks placed them at risk of harm. People said the staff were caring.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
This service was registered with us on 19 May 2019 and this is the first inspection.
Why we inspected
This was a planned inspection based on the previous rating.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led questions.
Following the inspection, the provider sent us an action plan detailing how they would control some of the more serious risks identified by our inspection to reduce the risk of ongoing harm.
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 recruitment, safe care and treatment, staff training and good governance at this inspection.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.
Special Measures
The service has been rated ‘Inadequate’ in the safe and well led questions and the service is therefore in special measures. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.