14 December 2022
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 Health and Social Care Act 2008.
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.
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was not a registered manager in post.
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 manager would be in the office to support the inspection. There was work being done at the office meaning we postponed our visit to the following week.
Inspection activity started on 25 October 2022 and ended on 17 November 2022. We visited the location’s office on 1 November 2022.
What we did before the inspection
We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.
We used all this information to plan our inspection.
During the inspection
We spoke with the acting manager and received feedback from 3 members of staff. We spoke to 4 people who used the service. We looked at 3 people’s care records and 3 staff files. We reviewed training and supervision records and documents relating to the management of the service and quality audits.
14 December 2022
About the service
Care in my Home West Essex is a domiciliary care agency providing personal care to people in their own homes. At the time of our inspection there were 17 people using the service.
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. There were 9 people receiving support with personal care.
People’s experience of using this service and what we found
Staff had not always been recruited safely. People had some concerns around the timeliness of their visits and staff were concerned there was not enough staff to cover absence.
People’s care plans were not always clear and detailed, but staff had good understanding of people’s needs and confirmed they received training. People were happy with the care provided.
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.
The acting manager had been in post a short time and did not yet have full oversight of the service. They had systems to monitor the quality of the service but documentation of this was not always consistent.
Feedback from people and staff regarding support from the office team was mixed.
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 good (published 8 July 2021).
Why we inspected
We received concerns in relation to staffing levels, training, quality monitoring and management of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
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 changed from good to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.
The acting manager was able to provide some assurances around specific concerns.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Care in my home West Essex on our website at www.cqc.org.uk.
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 breaches in relation to recruitment and oversight of the service at this inspection.
Please see the action we have told the provider to take at the end of this report.
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 work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.