Phemacare Ltd

Phemacare Ltd is a is a domiciliary care agency providing personal care to people in their own homes. The service was supporting 4 people with personal care at the time of our inspection.

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 and what we found

The provider's recruitment practices required improvement to ensure people are supported by suitable staff. The small staff team in place knew people well but care records such as care plans and risk assessments needed more information to give staff clear up-to-date guidance for managing people’s risks.

The provider had not followed their own policy in the administration of medication. When people required creams to be applied detailed records for staff to follow were not in place.

Staff adhered to infection control procedures and protected people from the risk of infection. Staff had completed safeguarding training and felt able to raise concerns; however, we found some staff required improved knowledge in safeguarding adults' procedures.

Checks and audits in place had failed to identify the areas for improvement found at this inspection including safe recruitment processes, care planning and risk assessments and medication records. The provider also needed to establish an audit system to monitor calls times and call duration to ensure people were receiving their assessed and required care.

The provider had not completed the last two Provider Information Returns (PIRs). This is information providers are required to send us annually with key information about the service, what it does well and improvements they plan to make.

People we spoke with said staff provided good care and staff working for the provider told us they felt supported.

The provider took immediate action in response to some of the areas we identified as requiring improvement and planned to take further action following the inspection.

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 requires improvement (published 04 December 2020), there was a breach of regulation and a warning notice was issued. At this inspection we found the provider was still in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service and to look at actions taken by the provider following the last inspection.

We undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained as requires improvement based on the findings of this inspection.

Enforcement

We have identified breaches in relation to fit and proper persons employed and governance systems 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 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. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

PhemaCare Ltd is a domiciliary care agency providing personal care to people in their own homes. The service was supporting 34 people with personal care in their own homes at the time of our inspection.

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

Systems to monitor the quality and safety of the service were not always effective and had not identified the areas for improvement found at this inspection. There was a risk people might not receive the right care, due to the lack of guidance for staff, which could put people at risk of harm. We saw that there were no individual risk assessments relating to COVID-19 for people using the service.

Spot checks of care worker visits in people’s homes, were completed to monitor that people received the support they needed; however, the records did not record any checks on the correct use of personal protective equipment (PPE). Following our inspection, the provider sent evidence to show they were taking action to rectify this issue.

Staff understood how and when to raise any safeguarding concerns. The provider had an electronic call monitoring system where staff logged in and out of their calls, which enabled care staff visits and punctuality to be monitored. People received their medicines when needed and staff where trained to administer people’s medicines safely.

The provider sought people's and their relatives' views about the service. Telephone calls were made to people on a regular basis to check they were happy with the care being provided.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for the service at the previous premises was Good, published on 4 October 2017.

Why we inspected

The inspection was prompted in part due to concerns received about missed or late calls and the use of personal protective equipment (PPE). Additional concerns were shared with us by local authority commissioners. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

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 a breach in relation to regulation 17, good 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.