Background to this inspection
Updated
20 January 2021
The inspection
This was a targeted inspection to check whether the provider had met the requirements of the specific concern we had about safe care, medicines management, and governance. We will assess all of the key questions at the next comprehensive inspection of the service.
Inspection team
The inspection team consisted of one inspector and an expert by experience. 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.
What we did before the 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 requested feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 16 December 2020 and ended on 18 December 2020. We visited the office location on 16 December 2020.
During the inspection
We spoke with two people who received a service and five family members. We spoke with the registered manager and six care workers We reviewed a range of records. This included four people's care and medication records. We looked at three staff recruitment files and associated training records. A range of records relating to the management of the service including audits, and, policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
20 January 2021
About the service
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. At the time of the inspection the service was providing care to two people.
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.
People’s experience of using this service and what we found
People told us that they felt safe, but this inspection found that the legal requirements were not met. Medicines were not always managed safely and record keeping was not robust. Care records and risk assessments did not include enough detail to keep people safe.
Systems were in place to ensure staff were recruited safely and people. However, gaps in employment had not been explored and verbal references had only been requested. The registered manager took action to address this after our inspection.
Quality monitoring required improvement as this had not identified the concerns we found at the inspection.
Staff had the skills and knowledge to deliver care and support in a person-centred way. Staff were caring and understood people’s likes, dislikes and preferences. They worked with people to ensure they received support how they wanted it. People told us their privacy and dignity were respected and their independence encouraged.
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.
People told us they felt able to share their views and raise concerns with staff or the registered manager.
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 5 September 2018 and this was the first inspection.
Why we inspected
This was a planned inspection based on the date of registration.
We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report. After the inspection the registered manager provided us with confirmation of action they had taken to mitigate the risks. You can see what action we have asked the provider to take at the end of this full report.
Enforcement
We have identified breaches in relation to safe care and treatment and good governance. Medicines were not always safely managed, and risks assessments did not contain enough detail to keep people safe. Quality monitoring had not identified the areas of concern that we found during the inspection.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.