14 December 2023
During a routine inspection
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.