Zest Living Homecare

Updated 1 September 2021

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 carried out by one inspector.

Service and service type

This service 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

We gave 24 hours’ notice of the inspection. This was because we needed to be sure the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 4 June 2021 and ended on 26 July 2021. We visited the office location on 21 July 2021.

What we did before the inspection

We reviewed information we received about the service. We sought feedback from the local authority and professionals who work with the service. The provider was 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 the information to plan our inspection.

During the inspection

We spoke with the registered manager, two members of staff and two external professionals. We also spoke with two people who were receiving personal care and two relatives who were involved in their loved one’s care packages. We reviewed a range of records, including four people’s care records, medication administration records, as well as a variety of records relating to the management of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at audit and governance data, as well a variety of policies and procedures.

Updated 1 September 2021

Zest Living Homecare is a domiciliary care agency providing personal care to adults in their own homes. The service was supporting five people at the time of the inspection.

Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. ‘Personal Care’ 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

People’s support needs and areas of risk were appropriately assessed, however we found that people did not always have the correct risk measures put in place to protect them from harm. Staff were not provided with detailed guidance they needed to follow as a measure of keeping people safe.

Quality assurance and governance measures were not always effectively monitoring or assessing the quality and safety of care being provided. Governance measures did not always enable the provider to review the provision of care and make necessary improvements. We have made a recommendation regarding improved quality assurance monitoring systems.

Medication management procedures were in place. Staff received the required medication training, had their competency levels regularly checked and had access to an up to date medication policy. However, we did find that one person did not have topical cream procedures in place; this was raised with the registered manager and immediately addressed.

Infection prevention and control (IPC) arrangements and procedures were in place. Staff received IPC training, were provided the relevant personal protective equipment (PPE) and knew the importance of complying with IPC policies as a way of keeping people safe.

Accident and incident reporting procedures were in place and people were safeguarded from harm. The provider had an up to date safeguarding policy that staff were familiar with and reporting procedures were clearly embedded. Staff expressed the importance of escalating any concerns and we received feedback that assured us that people felt safe when receiving care by Zest Living Homecare.

Recruitment of staff was safely and effectively managed. Pre-employment recruitment checks were conducted, disclosure and barring service (DBS) checks were carried out and suitable references were obtained. Staffing levels were regularly monitored, however at the time of the inspection it was noted that levels of staff had decreased; the provider explained that recruitment was an on-going activity.

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 supported this practice. We did note that some of the care records needed to clearly indicate that consent to care had been provided.

We received positive feedback about the quality and safety of care being provided. People, relatives and healthcare professionals told us safe, kind and compassionate care was delivered.

Staff were familiar with people’s support needs; people told us that they delivered care and support that was centred around their preferences and wishes. However, not all care records contained the same consistent level of tailored and person-centred information.

Concerns had been raised regarding the culture and regulatory responsibilities of the provider; these were discussed during the inspection. However, we did receive positive feedback about the positive approach to care that was being provided. One external professional told us, "They've been fabulous."

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 9 August 2019 and this was their first inspection.

Why we inspected

This was a planned inspection following their registration with CQC.

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 monitor the service.

We have identified a breach in relation to ‘safe care and treatment’ 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.