Background to this inspection
Updated
24 August 2023
The inspection
We carried out this performance review and assessment under Section 46 of the Health and Social Care Act 2008 (the Act). We checked whether the provider was meeting the legal requirements of the regulations associated with the Act and looked at the quality of the service to provide a rating.
Unlike our standard approach to assessing performance, we did not physically visit the office of the location. This is a new approach we have introduced to reviewing and assessing performance of some care at home providers. Instead of visiting the office location we use technology such as electronic file sharing and video or phone calls to engage with people using the service and staff.
Inspection team
This inspection was undertaken by 1 inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 7 April 2023 and ended on 10 May 2023.
What we did before the inspection
We used the information gathered as part of a monitoring activity that took place on 6 January 2023 to help plan the inspection and inform our judgements.
We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.
We used all this information to plan our inspection.
During the inspection
This performance review and assessment was carried out without a visit to the location’s office. We used technology such as calls and emails to enable us to engage with people using the service and staff, and electronic file sharing to enable us to review documentation. We visited the person who used the service in their own home on 9 May 2023.
Updated
24 August 2023
About the service
Joyfredwil Healthcare Ltd is a service providing personal care to people living in their own homes. It provides long term and short term care to people within the community. At the time of our inspection, the service supported 1 person.
People’s experience of using this service and what we found
Joyfredwil Healthcare Ltd is a small service and due to the number of service users at the time of inspection, the CQC were only able to rate the provider in the Safe and Well Led key questions.
The care people received was not safe. Medicine Administration Record (MAR) charts were not used to record where people were prompted or administered medicines. People were at risk of not receiving their ‘as needed’ PRN medicines as staff were not aware of when or how to administer these medicines.
Care plans were not person centred and did not reflect the care people were receiving. Risk assessments were not completed or did not reflect people’s needs and wishes.
While staff were recruited safely, they were not supported by regular supervision or competency checks. This meant that staff were not supported to develop or offered the opportunity for feedback and ongoing support and development.
The provider did not complete quality and assurances checks on the service and care they provided, this meant the provider did not have any oversight of issues and had not identified the failings found on inspection.
People were supported to have maximum choice and control of their lives, staff had in depth knowledge of people’s needs and supported them in the least restrictive way possible and in their best interests; however, the policies and systems in the service did not support this practice.
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 14 June 2019, and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement
We have identified breaches in relation to safe care and treatment and 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 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.