Background to this inspection
Updated
4 April 2020
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 undertaken by one inspector and an Expert by 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
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
The service had a manager registered with the Care Quality Commission. This means that they are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service short notice of the inspection. This was because it is a small service and we needed to be sure that the registered manager would be in the office to support the inspection.
Inspection activity started on 25 February 2020 and ended on 3 March 2020. We visited the office location on 25 February 2020 and 3 March 2020.
What we did before inspection
We reviewed all the information we held about the service. We contacted relevant agencies such as the local Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all this information to plan our inspection.
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 judgements in this report.
During the inspection
We spoke with six people and one relative. We also spoke with seven members of staff, the registered manager and the nominated individual, both of whom provide care and support to people as part of the staff team. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed six people’s care records, policies and procedures, records relating to the management of the service, including recruitment records and quality checks.
After the inspection
We continued to seek clarification from the registered manager to validate evidence found. These included policies and procedures and training records.
Updated
4 April 2020
About the service
Grace Homecare LTD is a domiciliary care agency providing personal care and support to people in their own homes. It provides a service to older people and younger adults. At the time of inspection, the service was providing personal care to 71 people.
People's experience of using this service and what we found
Medicines were not managed safely. The registered manager and provider acted at the time of the inspection to improve medicines records and the policy and procedure regarding safe management of medicines. However, the new records had not been fully introduced and staff were yet to be provided with training in their use.
Quality assurances processes were not robust enough. They had not been effective in identifying concerns found during this inspection relating to medicines, risk, training and care planning. Policies and procedures were not always up to date to reflect good practice guidance.
Staff did not always receive relevant training as identified by the provider’s policies. We have made a recommendation about staff training. Records did not clearly show how risk was managed. We have made a recommendation about the safe management of risk.
People said the care and support provided was safe. The provider had systems in place for responding to allegations of abuse. Overall, staff were knowledgeable about their responsibility in this area. Some staff were not aware of how to report concerns outside of the agency. Staff recruitment checks ensured staff were suitable to work with vulnerable people.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were involved in making decisions about their care and support needs. Staff showed a good awareness of respecting people’s choices and ensuring they had people’s consent to care.
People received care from staff who were kind, and who respected their privacy and dignity. People’s independence was also encouraged. People or their relatives contributed in planning their care and knew how to raise any concerns they may have. Care records were not always detailed or up to date. We have made a recommendation about care plans.
People and staff spoke positively about the registered manager and provider and told us they found them approachable. The provider and registered manager worked with other agencies to ensure people received the appropriate care and support. This included health professionals.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 27 July 2017).
Why we inspected
This was a planned inspection.
Follow up
We have asked the provider to send us an action plan telling us what steps they are to take to make the improvements needed. We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.