Immaculate Care Limited

Updated 1 May 2024

The inspection

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.

Inspection team

The inspection carried out by 1 inspector and an Expert by Experience carried out telephone interviews with people receiving support and relatives. 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.

Registered Manager

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 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 registered manager would be in the office to support the inspection.

Inspection activity started on 12 December 2023 and ended on 3 January 2024. We visited the location’s office/service on 14 December 2023 and 15 December 2023.

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 nominated individual who was also a director of the company. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records which included the care plans for 7 people, 4 staff member files and records relating to the quality assurance processes the provider had in place. Following the inspection, we spoke with 4 people who received support from the service and 3 relatives of people who received care. We spoke with 3 staff members and received feedback via email from 4 staff members.

Updated 1 May 2024

About the service

Immaculate Care Limited is a domiciliary care agency which provides care and support for people in their home. At the time of the inspection the service were providing support for 13 people from which 12 people were receiving the regulated activity of personal 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.

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

People’s medicines were not always managed in way to ensure they were administered as prescribed. Risks were not always identified. The provider had not always developed risk management plans to provide staff with guidance on how to mitigate risks. We made a recommendation in relation to the recruitment processes as they were not robust. This meant they could not demonstrate new staff had the required skills and knowledge for the role.

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. Staff had not completed training to meet people’s specific care needs.

Care plans did not always provide information on the person’s current support needs. People’s communication support needs were not always identified. The provider’s quality assurance processes were not robust enough to identify where improvements could be made to the way the service was provided.

The provider had made improvements to the staffing of the service with adequate travel time provided between visits and enough staff to provide the care. There had been no incidents and accidents, safeguarding concerns or complaints raised since the previous inspection.

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 15 December 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.

At our last inspection we recommended that the provider reviewed the nutritional and hydration needs of people to ensure their needs were properly supported. At this inspection we found the provider had not reviewed this information to ensure people’s needs could be met.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. We have found evidence that the provider needs to make improvements. Please see the key questions of Safe, Effective, Responsive and Well Led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement and Recommendations

We have identified breaches in relation to person-centred care, need for consent, safe care and treatment and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

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 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.

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.