Archived: Omega Integrated Care Limited

Updated 25 January 2022

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 two inspectors.

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 the service 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. However, our visit to the registered office was postponed for eight days because the registered manager was not able to assist with the inspection as planned.

Inspection activity started on 3 November 2021 and ended on 14 December 2021. We visited the office location on 11 and 12 November 2021 and 6 December 2021.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with two people who used the service and four relatives about their experience of the care provided. We spoke with four members of staff including two care workers, the assistant manager and the registered manager who was also 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 five people’s care records and two people’s medicines records. We looked at one staff member’s records in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed. Several documents we asked to look at were not accessible or made available to us by the registered manager during our inspection.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We contacted one health professional involved with people’s care but did not receive any feedback. We liaised with the commissioning authority and local safeguarding authority to monitor people’s safety.

Updated 25 January 2022

About the service

Omega Integrated Care Limited is a home care agency for adults including people living with dementia. At the start of our inspection the service was providing care to seven people. At the end of our inspection this had reduced to three people. All people using the service received support with 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.

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

People did not benefit from a well-led service. We received mixed feedback from people and their relatives about the management of the service. This ranged from serious concerns about staff training and conduct including the registered manager’s own abilities and professionalism, to positive feedback about the registered manager’s supportive approach and a staff member’s punctuality.

We found effective systems were not established or operated to monitor the quality and safety of the service, manage risks, or safeguard people from avoidable harm. Medicines were not safely managed to ensure people always received their medicine as prescribed.

People were not always supported by trained or experienced staff. The provider failed to ensure appropriate recruitment checks were completed to check staff were of good character, prior to their employment.

People were not supported to have maximum choice and control of their lives and staff did not always support them in their best interests; the policies and systems in the service did not consistently support good practice.

People did not experience holistic assessments or reviews of their needs. Care plans did not always provide appropriate guidance for staff to meet people’s health, nutrition and hydration needs, or their end of life wishes. Care plans did not clearly identify what support people needed and what they could do for themselves.

We received both positive and negative feedback from people and relatives about whether staff protected people’s dignity and treated them with respect. For example, one person told us a staff member was caring and good company. However, other feedback included “[staff] social skills are not good” and staff were not “compassionate”.

We found complaints were not well managed and people did not receive information about their rights or how to complain. The service did not notify the Care Quality Commission of certain events as required. This meant we could not check the service took appropriate action to anticipate and respond to concerns and risks to people.

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 8 April 2020 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about the service in relation to missed care visits which put people’s safety at risk. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the further details in all domains of this full report.

The provider did not take appropriate action to effectively address concerns or mitigate risks to people that were identified by inspectors.

Enforcement

We have identified breaches in relation to the provider’s governance, the management of risks and protection from abuse, how people are supported to meet their nutritional needs and treated with respect. Breaches were also identified in relation to people’s needs and preferences being assessed and reviewed, fit and proper staff employed and sufficient numbers of suitably trained staff. Other breaches include, staff use of equipment, management of complaints and notifying the Care Quality Commission of certain events.

We had serious concerns about the impact of poor risk management, governance and staffing upon people's safety. Therefore, during our inspection, 25 November 2021, we decided to impose urgent conditions upon the service. These conditions restricted the service from providing care to new people, without our permission. We also imposed conditions upon the service to provide us with evidence about actions taken to improve people's safety. The service did not submit evidence within the set timeframes and evidence submitted was insufficient to comply with conditions. We took this into consideration as part of our 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 continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Special Measures:

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 six 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.