The Care Quality Commission (CQC), has rated Compassion Home Care Limited inadequate and placed it in special measures to protect people, following an inspection in September.
Compassion Home Care Limited, in Orpington, provides personal care in people’s own homes. At the time of inspection 42 people were using the service.
The inspection was carried out following a review of information CQC held on the service.
Following this inspection, the service’s overall rating has dropped from good to inadequate, as have the ratings for safe and well-led. The ratings for effective, caring and responsive have dropped from good to requires improvement.
The service is now in special measures which means it will be kept under close review by CQC to keep people safe whilst it makes the improvements it has been told to. It will also be re-inspected to check on the progress of those improvements.
Antoinette Smith, CQC deputy director of operations in London, said:
“When we inspected Compassion Home Care Limited we were disappointed to find such a significant deterioration in care provided to people since our last inspection. We found leaders and their ineffective management didn’t support staff to provide the high-quality care that people have the right to expect.
“It was unacceptable that we found people’s basic care needs weren’t always being met and their care wasn’t dignified. At times some people weren’t being supported to brush their teeth or change their bedding, and one person hadn’t been supported to wash their hair for two weeks. We were also made aware that mouldy food was left in a fridge and one person told the service their carer sat on their phone the entire time and left early.
“Leaders weren’t managing risks to people’s health and safety or their care needs effectively, either when they first started using the service, or when their needs changed. For example, staff had no guidance for how to safely support one person who had trouble chewing food and was at risk of choking.
“Although staff had general training, they weren’t given training on how to support people using the service who had individual conditions like Parkinsons, multiple sclerosis or were post stroke. For example, there was no guidance for staff on supporting people with epilepsy when they have a seizure, even though people with epilepsy were using the service.
“Although leaders said they had audits in place, they hadn’t picked up on many of the issues we found at inspection. We also found that feedback given by both staff and people using the service wasn’t always acted on. They must make sure that people are listened to, and they are making improvements based on that feedback.
“It was clear that most staff wanted to provide good care but were being let down by the poor systems and processes leaders had in place. We saw individual staff trying to promote people’s independence and allow them to do things for themselves, but the systems in place didn’t enable staff to do so safely.
“We’ll continue to monitor the service closely to ensure the necessary improvements are made and keep people safe during this time. If improvements are not made by the time we next inspect, we will not hesitate to take further enforcement action.”
The inspection found:
- People’s care plans were not always detailed with information regarding individual needs. One person who spoke to inspectors was not aware a person they supported had dementia
- Safeguarding incidents were not being reported to the relevant authorities, including looking at the causes of unexplained bruising and fractures
- People’s medicines were not always administered or managed safely. Staff were unaware that one person’s cream medication was flammable and required a fire risk assessment. People with medication patches weren’t given these as prescribed. Staff were administering them at inconsistent times and not recording where they had been placed so they could be put on a different part of the body next time
- The service wasn’t working within the principle of the Mental Capacity Act by evidencing whether someone had capacity or not. Consent for care had been given by one person’s relative but there was no evidence they had the legal authorisation to do so.
However:
- Some people’s relatives gave positive feedback on the home and people said staff were kind and caring
- Staff told inspectors that relatives mainly supported people to access healthcare professionals. However, when required the provider liaised with relevant agencies such as district nurses and GPs to help ensure people’s need were met.
The report will be published on CQC’s website in the next few days.