Archived: Adorn Care Services Ltd

Adorn Care Services Ltd provides personal care support to people in their own homes. At the time of our inspection the service was supporting two people with personal care needs.

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

People and relatives gave positive feedback regarding the care they received. However, we found

the provider had failed to implement systems and processes to ensure people’s safe care. Risk assessments lacked detail and guidance for staff and no process was in place to monitor accidents and incidents. Medicines were not managed robustly and infection prevention and control guidance was not consistently followed.

The nominated individual and registered manager were unable to demonstrate the skills required to provide a registered service. Quality assurance audits had not been implemented which meant concerns were not identified. Systems to monitor the quality of the service such as spot checks and monitoring calls were not robust and not completed regularly. Following our last inspection, the provider forwarded an action plan stating what they would do to make improvements. At this inspection we found this had not been followed and there was a continued lack of managerial oversight.

Accurate, complete and contemporaneous records were not maintained. People’s care plans lacked information regarding how people preferred their support. Daily records were not organised, were difficult to read and did not consistently record the times and names of staff members visiting. The registered manager and nominated individual were unable to demonstrate understanding of the Mental Capacity Act 2005 and how this impacted on their work. The registered manager told us a number of records we requested were held on a system they had been unable to access for several months.

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 inadequate (published 18 January 2022). 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 carried out an announced comprehensive inspection of this service on 6 December 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, fit and proper persons employed and good governance.

We undertook this focused inspection to check whether Warning Notices in relation to Regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met and that the providers action plan had been followed. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

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 remains Inadequate.

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

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 and will take further action if needed.

We have identified continued breaches in relation to how risks to people’s safety are managed, medicines management, infection prevention and control and good governance at this inspection.

CQC’s regulatory response to the serious concerns found was to cancel the providers registration.

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. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service remains 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.

Adorn Care Services Ltd provides personal care and support to people in their own homes. At the time of our inspection the service was supporting three people with personal care needs.

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

Safe infection prevention and control measures were not always followed. COVID-19 testing was not carried out in line with government guidance and staff had not received guidance in how to keep people safe during the pandemic. Risks to people’s safety were not always identified and control measures to reduce risks had not been implemented. The risk of people sustaining harm due to this was reduced due to staff members knowing people well.

Robust medicines processes were not always followed. Staff competency in administering medicines had not been assessed and records were not always accurately maintained. Staff were not safely recruited as gaps and discrepancies in their records were identified during the inspection.

There was a lack of governance systems and oversight of the service. The nominated individual and registered manager were not fully aware of their responsibilities in managing a registered service and ensuring people received safe, effective care in line with regulations. Quality assurance systems were not effective in highlighting shortfalls in the service. Policies and procedures were not always accurate and understood by the nominated individual and registered manager. Records in relation to people’s care needs and the care they received lacked detail and were not always person-centred. The provider had not always notified CQC of significant incidents in line with their regulatory responsibilities.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. The nominated individual and registered manager had not ensured system for ensuring the principles of the Mental Capacity Act 2005 were implemented. Systems for ensuring training and supervision for staff was effective and regularly updated were not in place.

Staff knew people well and were able to describe their needs and preferences. Relatives told us they were able to discuss any changes to people’s care openly and that the nominated individual was always available. People were supported to maintain their dignity and independence and people’s religious needs were supported. People were supported to make choices in relation to what they liked to eat and drink and how they spent their time. Staff had access to contact details for health and social care professionals and any changes to people’s health was shared with relatives or other agencies.

Staff told us they felt supported in their roles and that the nominated individual and registered manager were always available to discuss any concerns.

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 27 October 2020 and this is the first inspection.

Why we inspected

This was a planned inspection based on the date the service was registered.

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 the management of risks to people’s safety, infection control practices, medicines management systems and the management oversight of the service. We issued Warning Notices to the provider and registered manager in relation to these concerns.

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.

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 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.

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, 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.