Cera - Plymouth

Updated 6 August 2021

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 Care Act 2014.

Inspection team

This inspection was completed by one inspector and two assistant inspectors. Three Experts by Experience telephoned people, who received care from the service, and relatives to obtain feedback about their experience. 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

Cera - Plymouth is a domiciliary care agency. It provides personal care to people living in their own homes. The service did not have a manager registered with the Care Quality Commission. The manager at the service had applied to register as manager and, this was in progress. The provider is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave short notice of the inspection because we needed to arrange consent for phone calls to people and their relatives and we needed to be sure the manager would be available to support the inspection.

Inspection activity started on 15 June 2021 and ended on 29 June 2021. We visited the office location on 29 June 2021.

What we did before the inspection

We reviewed information we held about the service. This included details about incidents the provider must notify us about, such as allegations of abuse, and accident and incidents. The local authority shared information with us. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgement in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with 47 people who used the service and 19 relatives to gain their views about the service. We also spoke with 20 staff which included care workers, care quality leads, domiciliary care manager, manager, peripatetic manager, regional director and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We received written feedback from a further 19 staff and two healthcare professionals.

We reviewed a range of records. This included nine people’s care plans and risk assessments. We looked at documentation relating to medicines for four people. We looked at four staff files and checked to ensure recruitment was safe. We also looked at records relating to the management of the service such as audits and a variety of policies and procedures developed and implemented by the provider.

Updated 6 August 2021

About the service

Cera Plymouth is a domiciliary care agency providing personal care to people in their own homes. The service provides care and support to people which include personal care, food preparation and medication support. At the time of this inspection, the manager informed us they were providing personal care to 354 people who used 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.

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

Most people were happy with the staff who supported them. However, some people told us they were unhappy about the timings of and, communication around their visits.

People told us they were happy with the support they received with their medicines. People’s medicines support needs were documented in care plans. We have made a recommendation about the management of some medicines.

Risks assessments were in place and gave staff guidance on how to reduce risks and actions to take. People told us, “My wife is safe in their care. I can tell that just by the general care they show during the professional activities they do” and, “I feel safe as the carers make sure that I don’t fall.” People and their relatives confirmed staff followed good infection control practice in their homes. They said they felt safe and staff wore personal protective equipment (PPE) appropriately.

A new provider took over the service in July 2020. The nominated individual told us they had a number of actions to complete when they took over the service and some remained in progress, mainly due to challenges they faced during the pandemic. They had made improvements in relation to risk assessments, care plans, and medicines. The provider had quality assurance systems in place. Although they had identified issues relating to timing of visits and communication, these had not been resolved. Following our inspection, the nominated individual assured us they had already made improvements to the scheduling of visits and the introduction of a new system had been brought forward.

People gave mixed feedback when asked if the service was well-led. A new manager started working at the service at the end of March 2021 and was in the process of applying to register as manager with CQC. They were keen to make improvements and were responsive during our 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 under the previous provider was Requires Improvement (published 9 January 2020). The service remains rated requires improvement.

Why we inspected

We carried out an announced focused inspection of this service in December 2019. Two breaches of legal requirements were found. The previous provider completed an action plan after the last inspection to show what they would do and by when to improve and meet the regulations relating to safe care and treatment and good governance.

We undertook this focused inspection to check they had followed the previous provider’s action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained the same. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Cera-Plymouth on our website at www.cqc.org.uk.

Enforcement

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 to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified one continuing breach in relation to governance of the service at this inspection.

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

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.