Archived: Slade Healthcare Ltd

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. At the time of the inspection the registered manager told us three people were using the service; two of whom received personal care.

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

People and their families were complimentary about the care and support provided. However, we found issues we had identified at the last inspection in relation to medicines, the assessment of risk including infection risk, staff recruitment and the oversight and management of the service had not all been addressed. The enforcement notice served following the last inspection had not been met.

There was an absence of effective systems to monitor the quality and safety of the service and it was not evident that some potential risks were safely managed, or that the provider identified any learning and made improvements to the service. There were repeat breaches of regulations. There was an absence of accurate records of people’s care or records related to the management of the service.

We found no evidence of harm, but we could not be assured that these areas of the service were being managed safely. This placed people at possible risk of harm or unsafe care. The provider and registered manager did not demonstrate they understood the requirements of their roles and the regulations related to the carrying out of the regulated activity.

There was an absence of a recorded assessment of people’s needs or detailed personalised care plan. Staff had received training and support, but records were not fully maintained to evidence the support and training provided to new staff or the more specialised aspects of people’s care. Records in relation to contact with health professionals or peoples’ communication needs were not well maintained.

People said they were supported with their nutritional needs where this was a part of their plan of care. 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.

People and their families commented that staff were kind and caring and that staff treated them with respect and dignity. Staff were able to tell us how they respected people’s diverse needs and encouraged them to be as independent as possible. The service had a complaints policy and process in place to manage any concerns raised by people.

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)

This service was registered with us on 17 May 2019 and this is the first comprehensive inspection. We carried out a targeted inspection of the service on 27 October 2020 following receipt of information raising concerns about specific aspects of the service provision. We found breaches of regulations 12,17 and 19. We took enforcement action and served a warning notice.

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection not enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

We carried out this comprehensive inspection to determine whether the warning notice we previously served in relation to Regulations 12,17 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met and to provide the first rating for this service.

You can read the report from our last inspection, by selecting the ‘all reports’ link for Slade Healthcare Limited on our website at www.cqc.org.uk.

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 the assessment of risk, management of medicines, staff recruitment and the way the service is managed.

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.

The overall rating for this service is ‘Inadequate’ 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 may 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.

Slade Healthcare Limited is a domiciliary care agency providing personal and nursing care to people in their own homes across London.

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. At the time of the inspection the registered manager told us four people were using the service; three of whom received personal care.

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

We found recruitment systems were unsafe and staff were employed without the range of required checks to ensure they were suitable to provide care to vulnerable people.

Risks in relation to people’s health and care needs were not always identified or assessed or guidance given to staff on how to reduce the risks.

Medicines were not safely managed as some risks in relation to medicines were not identified and staff did not all have medicines administration training or their competency assessed. There was an absence of effective infection control systems and absence of guidance for staff to refer to in relation to Covid -19 and the pandemic.

There was an absence of systems to monitor the quality and safety of the service and accurate records of people’s care were not maintained. The registered manager was not aware of all the requirements under the regulations.

These issues had not impacted on people but there were possible risks as a result of the absence of effective oversight and records.

People and their relatives were positive about the care provided. They told us they had the same consistent staff team and that staff were kind, caring, reliable and competent in their roles. They said staff wore appropriate PPE and understood infection control. People told us they received their medicines when they should.

Staff told us they felt well supported by the registered manager and office manager and that they worked well as a team. People and their relatives said they thought the service was well managed and organised and that they were involved in decisions about their care and support needs.

Rating at last inspection

This service was registered in May 2019 and has not yet been rated.

Why we inspected

This was a targeted inspection to check on specific concerns we had about possible risks to people using the service and the way the service was managed. A decision was made to inspect and examine those specific risks.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at entire key questions; only the part of the key question we are specifically concerned about. Targeted inspections therefore do not award or change a rating from the previous inspection. This is because they do not assess all areas of a key question.

Therefore, no overall rating for this service has been awarded at this inspection. We will award a rating following the first comprehensive inspection.

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 unsafe recruitment processes, risks to people in relation to their health needs, medicines and infection control and with the governance and management of the service

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 have requested an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.