A Cambridgeshire care company has been rated inadequate and placed in special measures by the Care Quality Commission (CQC), following an inspection in June and July.
Fen Homecare, a domiciliary care agency based in Waterbeach, received the unannounced inspection due to concerns CQC had about its staffing, governance and recruitment arrangements and the impact poor practice in these areas could have on people’s care.
The inspection substantiated these concerns and found people’s care did not always meet standards they have a right to expect.
At the time of inspection, the service provided personal care to 70 people in their own homes. This includes help with personal hygiene, eating and medicines.
In addition to being rated inadequate overall following the inspection, CQC rated the service inadequate for being safe and well-led. It rated it requires improvement for being effective, caring and responsive to people’s needs.
This was the service’s first inspection since it registered with CQC last year.
As Fen Homecare is now in special measures, it will be kept under close monitoring and inspected again within the coming months.
If CQC is not satisfied the service has made enough improvement to provide care that meets standards people have a right to expect following the next inspection, it will take further action to ensure people’s safety.
Louise Broddle, CQC head of adult social care inspection, said:
“People using Fen Homecare didn’t consistently receive safe care.
“The service lacked enough staff to meet the needs of the number of people using it. This led to late or missed calls and unacceptable pressure on frontline staff, three of whom had worked 53 days without a day off according to the service’s own records.
“We also found a lack of pre-employment recruitment checks for new staff meant people using the service were at increased risk of poor care or even abuse.
“As a consequence of the poor staffing arrangements, people weren’t always supported to have maximum control of their lives. This limited their independence and quality of life.
“Behind these issues was a lack of leadership to understand and address the challenges the service faced.
“We have been clear with the service’s leaders about what must be done to provide care that meets standards people have a right to expect, and we require them to make urgent improvements to avoid further enforcement action.
“We continue to monitor the service closely, and we will not hesitate to intervene if we become aware people are at risk of harm.”
The inspection found:
- The service’s staff had not received training about consent and independence, and people were not supported in the least restrictive way possible. The service’s policies did not support people to have choice and control of their lives
- People's mental capacity had been assumed instead of exploring if the issue was a language barrier rather than comprehension
- Staff worked unsafe shift patterns and long hours. Rotas did not ensure enough staff to support breaks or safe working
- People were supported with their medicines, but records did not always reflect safe medicines management and administration
- People told us language barriers sometimes meant they struggled to make their wishes known as staff could not always understand them verbally or through written instruction
- Information was not always in formats people could understand, which meant they were reliant on relatives to translate information about their care
- Pre-employment checks for new staff were insufficient
- Some staff did understand how to recognise or report abuse to safeguard people they were supporting
- People's care was not monitored for quality and standards
- Checks on staff knowledge and skills, to ensure they could meet people's needs, were not made
- An adequate complaints system was not in place.
However:
- People told us staff were kind and caring and treated them nicely. Staff understood how to promote people's dignity and privacy.