3 February 2022
During an inspection looking at part of the service
Care focal is a domiciliary care agency which provides care to people in their own homes. 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 27 people were receiving personal care.
People’s experience of using this service:
Risks were not always identified or updated, and risk management plans were not in place to manage these risks. People's medicines were not always safely managed. People who had a ‘Do Not Attempt Resuscitation’ form (DNAR) in place, did not have information in their care plans about where in their home this could be located. The provider's recruitment process was not robust, and staff were not always recruited in line with the recruitment policy. Assessments were carried out prior to people joining the service but they did not always ensure that people’s needs could be met and were not used to develop care plans. People and/or their relatives were not involved in planning their care and support and care plans were not always updated. People’s capacity to consent to their care and support was not documented. People who had a lasting power of attorney did not have these details recorded in their care plans. The provider’s quality assurance systems were not effective. Feedback was sought from people about the service, but the provider did not always act upon shortfalls identified.
People told us they felt safe. There were appropriate adult safeguarding procedures in place to protect people from the risk of abuse. People were protected from the risk of infection. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff were supported through training and supervisions. Staff supported people to eat and drink enough to meet their needs. The provider did work within the principles of Mental Capacity Act (MCA). People had access to healthcare professionals when required to maintain good health. The provider worked in partnership with other healthcare agencies.
Rating at last inspection:
This service was registered with us on 08/04/2020 and this was their first inspection.
Why we inspected:
The inspection was prompted in part due to concerns received about neglect, late visits, lack of risk assessments and poor medicine management. A decision was made for us to inspect and examine those risks.
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 and will take further action if needed
We have identified breaches in relation to safe care and treatment, person-centred care, fit and proper persons employed, and good governance.
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 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.