16 May 2023
During an inspection looking at part of the service
MyCareCrew Ltd is a domiciliary care agency which provides support and personal care to people living in their own home. Not everyone who used the service received personal care. The Care Quality Commission (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 our inspection 12 people were receiving a regulated activity from this service.
People’s experience of using this service and what we found
People told us they felt safe, and we identified some improvements had been made in relation to the implementation of formal risk assessments to mitigate risks to people. However, we found specific risk assessments had not consistently been completed, as required to provide guidance to staff on how to monitor and manage people’s specific conditions.
Recruitment checks were not always fully completed to ensure staff were suitable to work with people using the service. People and relatives all confirmed staff were on time for care calls, they were not rushed and received support from a consistent staff team. People's safety was promoted through the prevention and control of infection. Staff had access to personal protective equipment (PPE), such as disposable aprons and gloves and worn these as required.
We could not be assured staff received an effective induction or appropriate training to provide them with the skills required to support people effectively and safely. Although it was evident staff had not received training in a timely way, all people and relatives we spoke with were highly complementary about the skills of the staff.
Where required staff ensured people were supported to have good levels of hydration and nutrition. Staff supported people to access healthcare professionals when they needed them and worked alongside health and social care professionals to ensure a joined-up approach to people's care. 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 were treated well by staff, who were kind and caring and treated them with dignity and respect.
Quality and safety monitoring systems had failed to identify the concerns we found in relation to recruitment, risk management, the induction process and training. These concerns had also been highlighted at the last inspection. The actions taken to address these issues following the last inspection had not resulted in effective improvement. This placed people at continued risk of receiving unsafe care and treatment.
At the last inspection we identified the registered manager was providing a high number of care hours each week which affected their ability to complete their management tasks effectively. This continued to be the case.
The management team were open and transparent and understood their regulatory responsibilities to notify CQC of all significant events that occurred in the service. The registered manager understood their formal responsibilities regarding duty of candour. The management team kept in regular contact with people, checking if they were happy with the service they received and if any changes were needed. People, relatives, and professionals were exceptionally positive about the culture of the service. They described the service as well led and told us they would recommend this service to others.
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 requires improvement (published 6 April 2022) and there were breaches of regulation. We also made 3 recommendations. These recommendations included the provider to review and implement best practice guidance in relation to individual risks; review and implement best practice guidance for the assessment of people's needs and the provider review their duty of candour policy so they are fully aware of their responsibilities in relation to this.
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 the provider remained in breach of 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 of safe, effective and well-led which contain those requirements. No areas of concern were identified in the other key questions. We therefore did not inspect them. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has remained 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 MyCareCrew Ltd on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified 4 breaches of regulation including, Regulation 19 (Fit and proper persons employed), Regulation 12 (Safe care and treatment), Regulation 18 (Staffing) and Regulation 17 (Good governance).
Please see the action we have told the provider to take at the end of this report.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good.