Background to this inspection
Updated
10 February 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
This inspection was carried out by one inspector, an Expert by Experience and a second inspector supported with calls to staff. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
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 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 14 December 2020 and ended on 23 December 2020. We visited the office location on 14 December 2020.
What we did before inspection
We reviewed information we had received about the service since the last inspection. The provider was not 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 of this information to plan our inspection.
During the inspection
We spoke with eight people who used the service and six relatives about their experience of the care provided. We spoke with nine members of staff including five care workers, the project manager, the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data, quality assurance records, policies and procedures, Covid-19 risk assessment processes, staff rota’s and recruitment documents.
Updated
10 February 2021
About the service
Ignite Health and Homecare Services Ltd is a domiciliary home care service providing personal care to 31 younger and older people in their own houses or flats at the time of the inspection.
People’s experience of using this service and what we found
Risks were not consistently assessed and mitigated and care plans did not always reflect people’s current need. People did not always feel involved in the care planning process which meant care was not always person centred.
The registered manager had not consistently maintained oversight of the safety and quality of the service and did not have a regular presence in the service. Auditing and monitoring of delegated tasks required improvement.
Medicines were not consistently safe and well managed, staff did not have all the information needed to support safe administration in line with national guidance. Medicine audits had not identified issues found during inspection.
There was not consistently enough staff to meet people’s needs. This meant staff were frequently late and call durations were shorter than agreed. The lack of recruitment and contingency plans meant we were not reassured that staffing numbers would be sufficient if there were high numbers of staff sickness or adverse weather affecting travel. We have recommended that the provider and registered manager look at how they will manage staff sustainability going forward.
People were not supported to have maximum choice and control of their lives and staff did not consistently support them in the least restrictive way possible and in their best interests; the policies in the service did support this practice but the policies and systems had not been implemented at the time of the inspection. We have recommended that this is reviewed to ensure mental capacity assessments are completed where required, legal authority of decision making on a person’s behalf is evidenced and staff understanding is supported in this area.
People told us they felt safe with staff, some people reported staff were rushed and not as gentle as others but still kind and caring.
Staff were recruited safely and completed an induction and mandatory training. Training for people’s more complex needs such as pressure area care and catheter care was not always completed for staff working in these areas. Some staff required a refresh of their training in line with the providers policy.
People’s religious and cultural needs were considered and planned into care. Staff had access to the providers equality and diversity policy and staff were trained in supporting people with protected characteristics such as dementia and learning disability.
Staff had access to and were using personal protective equipment (PPE) to prevent the spread of infection.
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 20/03/2020 and this is the first inspection.
Why we inspected
We received concerns in relation to staff time keeping and attendance and the safe management of medicines. As a result, we undertook a comprehensive inspection as this service had not yet been inspected and rated.
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 breaches in relation to the safety and management of the service 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 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.