Vermuyden Care

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 inspection, the service was providing personal care to 22 people.

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

There was mixed feedback from people and their relatives. Some people were unhappy about staffing, consistency of staff, and communication with the office. However, other people’s comments reflected improvements made since the last inspection.

A new registered manager had been employed since the last inspection and had made significant improvements to the systems of governance. There was better management oversight of the service. The service used a range of audits and tools to assess the quality and safety of the service. Although, some improvements had been made relatively recently, they were on-going, and needed embedding into practice. The service was improving the way they engaged with and sought the views of people, those close to them and staff to improve the service.

Improvement had been made to ensure staff were recruited safely and that people's medicines were well managed. Staff received appropriate training, which was relevant to their role and to people's individual needs. Staff were clear on how to identify and report any safeguarding concerns.

Good progress had been made in ensuring people’s risk assessments and care plans were personalised, detailed. and included information about people's preferences. People’s health and wellbeing were well supported.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was inadequate (published 8 January 2021) and there were two breaches of regulation. 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 evidence of improvement in these areas and the provider was no longer in breach of the regulations.

Why we inspected

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 inspection was prompted in part due to concerns received about staffing level, including missed and late care calls and the management of the service. A decision was made for us to inspect to examine the risks. We found no evidence during this inspection that people were at risk of harm from these concerns.

Please see the safe and well-led sections of this full report

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.

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.

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

Follow up

Following this report being published we will discuss with the provider how they will make changes to ensure they improve their rating to at least good. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Vermuyden Care is a domiciliary care agency providing support for people in their own homes. 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. The service was supporting 35 people at the time of the inspection.

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

Everyone we spoke with was positive about their experience of receiving care, and told us care staff were friendly and respectful. However, we found multiple concerns relating to the governance of the service, and whether the service was operated safely.

Staff had not received training in many areas required for them to carry out their role safely, including medicines management, infection control and moving and handling. Where they had received training in these areas, it was delivered by the manager who told us they were not qualified to deliver training.

Where risks had been identified, there were not always suitable risk assessments in place.

People using the service did not have access to their care plans, and the manager confirmed people had not been involved in developing their care plans. People had not given formal consent to their care, and where people lacked capacity, the provider had not undertaken any best interest decisions.

Staff recruitment was not always undertaken safely; the required background checks had not been carried out for all staff.

The manager told us they were not meeting the requirements of the Accessible Information Standards, and could not meaningfully describe what steps they intended to take to address this.

The manager had not registered with CQC despite having been in post for five months. The registered person had previously told CQC that the manager’s application had been submitted, indicating they did not have oversight of this.

The governance arrangements within the service were not fit for purpose. Shortfalls across the service, such as inadequate staff training, poor risk management and breaches of regulation, had not been identified and addressed via any audit system.

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 in April 2020 and this is the first inspection.

Why we inspected

This was a planned inspection in line with CQC’s inspection programme.

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 safety, staff training, care quality, consent and 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 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.

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.