Phemacare Ltd

Phemacare Ltd is a is a domiciliary care agency providing personal care to people in their own homes. The service was supporting 51 people from the location, with personal care in their own homes at the time of our inspection.

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

We were hindered in carrying out this inspection due to records not being available when requested whilst at the location. This was due to documents and files being removed from the location and the lack of organisation of stored documents. This was also identified at the previous inspection.

There continued to be a lack of provider oversight which meant risks to people’s safety had not been responded to appropriately. Systems to monitor the quality and safety of the service were ineffective and placed people at the risk of harm. The systems in place had failed to identify the areas for improvement found at this inspection including the safe administration of medication and care planning.

Care plans were not in place for known health conditions for all people, to enable staff to have the information they needed to mitigate risk and meet or respond to their needs.

People we spoke to said they felt safe , and individual staff were kind and caring.

Staff we spoke to told us they had received some training to meet people’s needs. However, we saw from records that staff still had not completed training on all of the health conditions of people using the service, to give them the knowledge and skills to support them safely. This was identified at the last inspection.

Medication administration records (MAR) did not always include the current list of medications prescribed for people using the service. This meant care staff did not have accurate records to refer to, ensuring they were giving the correct medication at the correct time.

Spot checks of staff visits in people’s homes were completed to monitor that people received the support they needed.

Audits need to be improved to provide clear and robust information and evidence of outcomes for people.

Systems and process which were in place were not robust to protect people from potential harm.

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 previously inspected 12 November 2020 and it was rated as requires improvement.

Why we inspected

We carried out an announced inspection of this service on 24 March and 08 April 2021. Breaches of legal requirements were found.

The provider was issued with Warning Notices for breaches identified at the last inspection in relation to Regulation 12 Safe care and treatment, Regulation 17 Good governance Social Care Act 2008 (Regulated Activities) Regulations 2014. The Provider had completed an action plan to show what they would do and by when to improve. During the inspection we found evidence that the action plans had not been met.

We undertook this responsive inspection to check the provider had followed their action plan and to confirm they now met legal requirements.

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

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 monitor the service 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 safe care and treatment of people using the service, good governance and safe recruitment process at this inspection.

Please see the action we have told the provider to take at the end of this report.

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 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.

Phemacare Ltd is a is a domiciliary care agency providing personal care to people in their own homes. The service was supporting 46 people from the location, with personal care in their own homes at the time of our inspection.

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

We were hindered in carrying out this inspection due to records not being available when requested whilst at the location. This was due to documents and files being removed from the location and taken to another office for scanning purposes and the lack of organisation of stored documents.

There was a lack of provider oversight which meant risks to people’s safety had not been responded to appropriately. Systems to monitor the quality and safety of the service were ineffective and placed people at the risk of harm. The systems in place had failed to identify the areas for improvement found at this inspection including the safe administration of medication and care planning.

Care plans were not in place for known health conditions to enable staff to have the information they needed to mitigate risk and meet or respond to their needs.

People we spoke to said they felt safe however, one relative told us that they had to show and tell staff how to support their family member correctly, as they did not know how to use the hoist.

Staff we spoke to told us they had received some training to meet people’s needs. However, we saw from records that staff had not completed training on all of the health conditions of people using the service, to give them the knowledge and skills to support them safely.

Medication administration records (MAR) did not always include the current list of medications prescribed for people using the service. This meant care staff did not have accurate records to refer to, ensuring they were giving the correct medication at the correct time.

Spot checks of staff visits in people’s homes were completed to monitor that people received the support they needed.

Audits need to be improved to provide clear and robust information and evidence of outcomes for people.

Systems and process which were in place were not robust to protect people from potential harm.

Staff we spoke to told us they understood their roles and responsibilities, had received some training and felt supported by the management.

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 12 February 2020 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about medicines and infection control. A decision was made for us to inspect and examine those risks.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions.

The overall rating for the service following the first inspection is Requires Improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. 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 monitor the service 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 safe care and treatment of people using the service and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

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 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.