Background to this inspection
Updated
6 August 2020
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 conducted by two inspectors and follow up calls were made by another inspector.
Service and service type
Executive Care Agency is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
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.
Notice of inspection
The inspection was announced less than 24 hours before the visit. This was because we needed to be sure that the provider or manager would be in the office to support the inspection.
Inspection activity started on 7th July 2020 and ended on 14th July 2020. We visited the office location on7th July 2020.
What we did before the inspection
We contacted the local authority for feedback about 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 to six members of staff including the registered manager. We spoke to three people using the service and four relatives. We looked at four peoples care plans. We looked at 6 staff files in relation to recruitment and staff supervision. In addition, we looked at a variety of documents relating to the management of the service, including policies, procedures and quality checks.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
6 August 2020
Executive Care Agency is a domiciliary care service that provides personal care to people living in their own homes. At the time of our inspection visit, the service was providing personal care support to 47 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
A new risk assessment process had been introduced. However, not everyone’s information or risk assessments had been updated although the provider was working to address this. People were cared for by staff in a way that kept them safe and protected them from avoidable harm. People were supported by enough staff who were available to respond to their needs in a timely manner. People received their medicines when they needed them, and systems were in place to ensure the administration of medicines was audited. However, not all staff members had received an assessment of competency to ensure they were safe to support people. Accidents and incidents were investigated, and measures were taken to prevent re-occurrences. Staff knew and followed infection control principles. We saw positive feedback about the quality of care. There were effective governance systems in place to monitor the quality of service and the health, safety and welfare of people. However, these systems have been newly introduced and need to be embedded into practice and sustained over time.
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 inadequate (published 8th May 2020) and there were multiple breaches of regulation. 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 some of the regulations.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 9th March 2020. Breaches of legal requirements were found. 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, failure to comply with a condition, need for consent, good governance, fit and proper persons employed and staffing.
We undertook this focused inspection due to concerns about staffing and the management of the service and 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 Safe and Well-led.
The ratings from the previous comprehensive inspection for the other key questions were not looked at on this occasion but were used in calculating the overall rating at this inspection. The overall rating for the service has changed from inadequate to requires improvement. 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 Executive Care Agency 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 reinspection programme. If we receive any concerning information we may inspect sooner.