About the service Yowsun Care is a domiciliary care agency providing personal care to people in their own home. At the time of the inspection there were four people using the service.
People’s experience of using this service and what we found
The service was providing care to support people with complex needs when being discharged from hospital. The registered provider carried out an initial assessment, but these lacked sufficient detail to understand what care and support people needed. The registered provider did not have risk assessments in place which identified risks to people’s safety and wellbeing.
People told us they had experienced a missed or a late visit, the registered manager did not have systems in place to monitor when a late or missed visit had occurred.
People were not always supported by staff who had the correct training and competency to meet their assessed needs. Systems were not in place to ensure staff would be appropriately supervised. The registered manager had failed to carry out recruitment checks to ensure that new employees were suitable to deliver care.
The registered provider did not have adequate control measures in place to reduce the spread of infection.
Not all staff had been given training to administer people's medicine. The registered manager could not demonstrate staff were competent to administer medicine.
The leadership of the service did not always support the delivery of high-quality, person-centred care. They had failed to ensure robust systems were in place to demonstrate staff were suitably recruited, had the correct training and were competent to carry out the role. The systems to monitor and check the quality of the service people received were ineffective because, they did not identify the issues we found.
Some people told us communication between themselves and the office was poor and needed to improve.
This inspection was in part triggered by information of concern received following a recent safeguarding incident. At the time of the inspection, the registered manager was working to improve certain areas of the service.
People were not always 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 in the service did not support this practice.
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 02 April 2020 and this is the first inspection.
Why we inspected
The inspection was prompted in part due to concerns received about the lack of safe recruitment checks and staff training and supervision. A decision was made for us to carry out a comprehensive inspection to examine those risks.
We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Responsive 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. 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 safe care and treatment, staffing, fit and proper persons, and good governance. This is because some people did not always receive care in a safe and effective way, because staff were not always trained or competent to meet people’s complex needs. Care plans and risk assessments were not always in place or did not reflect the care being delivered. Audits to make sure people received a good quality of care were either not in place or only new operated and did not identify the issues we found.
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.
The overall rating for this service is 'Inadequate' and the service is therefore in 'special measures'. This means we will keep the service under review and, if we do not propose to cancel the provider's registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it, and it is no longer rated as inadequate for any of the five key questions, it will no longer be in special measures.