Kare Plus Oxford

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

Risks to people had not always been fully assessed or strategies recorded to reduce the risk of harm. Staff did not always have sufficient information or the skills and knowledge to support people safely. Training records did not evidence staff had received adequate training on people’s specific needs.

When people sustained an injury, records were not always clear on how the injury occurred, the size, shape or colour of injury or when the injury had healed. Investigations for incidents or accidents were not consistently in place.

People did not always know which staff were supporting them for each visit, staff did not always turn up on time or stay the allocated amount of time. However, people stated staff were kind and caring. Staff recruitment required improvement to ensure all necessary checks had been completed before staff worked with people. Policies and procedures were in place but had not been consistently followed.

Medicine management required improvement. Although we found no risk of harm, records were not consistently completed to ensure medicines were given as prescribed.

Systems and processes to ensure good oversight of the service, to identify concerns and make improvements were not effective or embedded into practice. Issues found on inspection had not been identified previously by the provider's own audits or reviews.

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 did not always support this practice.

Staff felt supported by the manager. However, regular meetings were not held to discuss concerns, make suggestions or share information. Not all staff had received a spot check to check if staff were working in a safe, person-centred way or if they were following policies and procedures.

Relatives were kept up to date on any changes in people's need, incidents or accident that occurred. Staff supported people to access healthcare support if needed.

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 8 June 2022)

Why we inspected

We received concerns in relation to management oversight and staffing. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Kare Plus Oxford on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to risk management and oversight at this inspection.

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

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Kare plus (Oxfordshire) is a domiciliary care agency providing care to people in their own homes in the Oxfordshire area. At the time of our inspection 26 people were receiving the regulated activity of personal care from the service. Not everyone using the service received personal care. CQC only inspects where people receive personal care, which 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

People were kept safe from abuse and harm, and staff knew how to report any suspicions concerning abuse. The service had systems to report and investigate concerns. Risk assessments identified how potential risks should be managed to reduce the likelihood of people experiencing harm. Staff understood the risks to people and delivered safe care in accordance with people's support plans. There were enough staff to keep people safe and meet their needs. Robust recruitment processes aimed to ensure only suitable staff were selected to work with people.

People told us staff were mostly punctual, and no one told us they had experienced a missed visit. People were informed when their care visits would be taking place. Support visits were monitored through an electronic monitoring system that alerted management if staff were running late.

Each staff member had received induction and training to enable them to meet people's needs effectively. We saw that supervision/spot check meetings for staff were held regularly and staff felt supported by the management to perform their role. People were supported to have maximum choice and control of their lives and staff provided them with care in the least restrictive way possible and acted in their best interests; the policies and systems in the service promoted this practice.

People's care plans were person-centred and focused on what was important to people. Care plans were regularly reviewed, and people and their relatives were involved in the reviews

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Most people, and staff spoke positively of the management; they found them approachable and supportive. People told us they were aware there was a new manager in post. Staff were given appropriate responsibility which was continuously monitored and checked by the manager. There were systems to monitor, maintain and improve the quality of the service. The manager told us as the service grew, these systems would be expanded and refined.

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 Good (published 6 January 2021).

Why we inspected

The inspection was prompted in part due to concerns received about poor care, staff working without sufficient background checks, lack of staff, administering medicines, and infection control practices. A decision was made for us to inspect and examine those risks. This was a targeted inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Kare Plus is a domiciliary care agency. It provides personal care to people living in their own homes in Oxford and the surrounding areas. The service was providing personal care for 45 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

People received safe care from skilled and knowledgeable staff. People told us they felt safe receiving care from the service. Staff understood their responsibilities to identify and report any concerns. The provider had safe recruitment and selection processes in place.

Risks to people's safety and well-being were managed through a risk management process. There were sufficient staff deployed to meet people's needs. Medicines were managed safely, and people received their medicines as prescribed.

We received positive feedback from people and relatives. The feedback reflected staff were very kind, caring and committed. People complimented the continuity of care provided by regular staff which contributed to building of meaningful relationships. Staff recognised what was important to people and ensured an individually tailored approach that met people's personal needs, wishes and preferences was delivered.

People were supported by caring staff that knew them well. People were supported to maintain relationships with their families and friends. People's independence was promoted, and they received support to achieve their goals and reduce social isolation.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to maintain good health and to meet their nutritional needs.

The service was well-led by a registered manager who was committed to improving people’s care. The provider had quality assurance processes in place which were effectively used to drive improvement.

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

Rating at last inspection

This service was registered with us on 05/04/2019 and this is the first inspection.

Why we inspected

This was a planned inspection.

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.