Archived: Major Oak Homecare

Updated 3 March 2021

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the registered provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak and to identify good practice we can share with other services.

Inspection team

Our inspection was conducted by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Head Office aka Major Oak Homecare is a domiciliary care service, registered to provide personal care to people living in their own homes.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

The provider had recently employed a new manager for the service (‘the new service manager’). At the time of our inspection she had been in post for about a month and was in day-to-day charge of the service, with support from the registered manager. The new service manager had started the process of applying to become the registered manager, at which point the existing registered manager planned to deregister and take on a new role within the service, focusing on training delivery.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that senior staff would be in the office to support the inspection.

What we did before the inspection

In planning our inspection, we reviewed information we had received about the service. This included notifications submitted by the provider. Notifications are events which happened in the service which the provider is required to tell us about.

During the inspection

We conducted our inspection between 1 and 11 February 2021.

During the inspection we spoke with the new service manager; the registered manager; the deputy manager; the nominated individual; four members of the care staff team and 16 service users or relatives.

We reviewed a range of written records including four people’s care plan, five staff recruitment files and information relating to the auditing and monitoring of service provision.

After the inspection

We reviewed further information we had requested from the provider, including data relating to call scheduling and medicines administration.

Updated 3 March 2021

About the service:

Head Office aka Major Oak Homecare is a domiciliary care agency. It provides personal care to people living in their own homes in the community. The service operates in and around the city of Lincoln. At the time of our inspection, 43 people were using the service.

People’s experience of using this service and what we found:

Since our last inspection, the provider had taken some steps to strengthen the monitoring of service quality and to mitigate risks to people's safety. As a result, there had been recent improvements in medicines management and the deployment of staffing resources to meet people's needs. However, significant inconsistencies remained and further action was required.

The provider had assessed risks to people's safety but, for some risks, staff required more detailed guidance to help manage them safely. The provider had strengthened infection control measures in response to the COVID-19 pandemic, although action was required to ensure used PPE was disposed of safely.

The provider had failed to submit an action plan requested after our last inspection of the service. The provider had also failed to display the inspection rating on their website.

Staff knew how to recognise and report any concerns to keep people safe from harm. Staff recruitment was safe. There was some evidence of organisational learning from incidents and events.

Most people provided positive feedback on the caring nature of staff. Despite concerns about call timings and staffing continuity, most people were also generally satisfied with the management of the service overall. Staff were happy in their work and spoke highly of the positive impact made by the new service manager.

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 6 May 2020) and there was a breach of regulations. At this inspection enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected:

We received concerns about the safety of care delivery and organisational governance. As a result, we undertook a focused inspection to review the key questions of Safe and Well-led only.

We reviewed the information we held about the service. No significant issues 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 remains Requires Improvement. This is based on the findings at this inspection. The service has been rated as Requires Improvement at the last two inspections.

Enforcement:

At this inspection we have identified a continued breach of regulations due to continued shortfalls in organisational governance and the monitoring of service quality.

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

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.

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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.