Background to this inspection
Updated
18 May 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 short notice of the inspection. Due to the COVID-19 pandemic we wanted to review documentation remotely and arrange to speak with people, relatives and staff by telephone. This helped minimise the time we spent in face to face contact with the manager, staff and people who used the service.
Inspection activity started on 6 April 2021 and ended on 23 April 2021. We visited the office location on 9 April 2021
What we did before inspection
We reviewed information we had received about the service since the last inspection. We also sought feedback from the local authority. 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.
During the inspection
We spoke with seven people who used the service about their experience of the care provided. We also spoke with 10 members of staff including, care staff, the registered manager, the regional manager, the head of training and quality 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 three people's care records and several medication records. We looked at four staff files in relation to recruitment, training and staff supervision. We also looked at quality monitoring records relating to the management of the service such as policies and audits.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
18 May 2021
About the service
Cheshire East Care at Home Group provides care and support to people in their own homes across the Cheshire area. 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 there were 29 people receiving personal care.
People’s experience of using this service and what we found
Overall people were satisfied with the support they received. Some people told us there had been an improvement to the consistency of care calls, whilst others felt this could be improved further.
The provider had made improvements in relation to the areas of concern we found at our last inspection, including medicines management, staff training, safeguarding and regulatory requirements. However, further improvements were required in relation to records relating to medication and The Mental Capacity Act (MCA) records. Quality monitoring processes needed to be fully embedded.
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. However, there remained some gaps in staff knowledge.
We have made a further recommendation about following MCA guidance.
There was ongoing work to ensure people received a consistent staff team. The provider had introduced a new electronic care management system (app) to monitor care visits, which provided more reliability than the previous one in place.
Following the last inspection, the provider had arranged safeguarding training for all staff. Records were more robust, demonstrating that safeguarding concerns had been reported appropriately through relevant procedures.
The provider had reviewed systems to ensure safer recruitment procedures were being followed.
Improvements had been made to the administration of medicines, however we found some recording issues and further staff training was being planned.
Infection control training had been provided to staff and changes to government guidance were considered and implemented. Staff had access to appropriate PPE.
Improvements had been made since the last inspection in relation to staff training, supervision and support.
The governance systems in place were more robust. There had been a management restructure and several new roles had been recruited to. However, whilst there had been improvements in the provider’s governance systems, these needed to be developed further and fully implemented.
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 inadequate (published 12 January 2021). There were multiple breaches of regulation, including safe care and treatment, safeguarding service users, ensuring fit and proper person are employed, staffing and good governance. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
This service has been in Special Measures since 7 January 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This was a planned inspection based on the previous rating.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe, effective and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Cheshire East Care at Home Group on our website at www.cqc.org.uk.
Follow up
We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.