ICare Nottingham Ltd

Updated 9 May 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was carried out by one inspector.

Service and service type: Icare Nottingham is a domiciliary care service and provides personal care to people living in the community.

The service had a manager registered with the Care Quality Commission. This means that they and the provider 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 48 hours’ notice of the inspection visit because it is small, and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

What we did:

Before we inspected we asked the provider to send us their Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed information, which included statutory notifications. A notification is about important events, which the provider is required to send us by law. We used this information to inform our inspection plan.

People who used the service were not able to speak with us, but we did speak with three relatives. We also spoke with the provider’s representative and two care staff.

We looked at four people’s care records to check that the care they received matched the information in their care plans. We reviewed four staff files to see how staff were recruited and the training records to check the training provided to staff. We looked at the systems the provider had in place to ensure the quality of the service was continuously monitored and reviewed to drive improvement

Updated 9 May 2019

About the service: ICare Nottingham Ltd is a domiciliary care service that provides care to people in their own home. There were four people receiving a regulated activity of personal care at the time of our inspection.

People’s experience of using this service:

People’s needs associated with risk had been assessed, but not fully explored to ensure staff had sufficient guidance to support and manage any known risks. Recruitment processes were not robust enough to ensure people employed were safe to work with the people who used the service. Where people required medicine, this was administered as prescribed, but the provider did not always follow their policy and procedure when administering medicines for people. People and their families felt safe with the staff that cared for them. Safeguarding systems were in place. People were protected from cross contamination because staff followed infection control policy and procedures. Systems were in place to monitor Incident and accidents

People’s needs were assessed and included protected characteristics under the equality act 2010 and this was considered in people’s care plans. Staff were knowledgeable about the people they cared for, but when they cared for people living with a condition, such as, dementia the care plan lacked instruction how staff should care for the person. People consented to the care and support, but those who lacked capacity had no mental capacity assessments completed for decisions they needed to make, or decisions made in their best interest. Staff attended an induction and training relevant to their role, including a basic English and Maths test. People were supported to eat and drink according to their culture, religion and preferences. The provider worked with other professionals and implemented recommendations to help achieve a positive outcome for people’s health and wellbeing.

People were cared for by kind, compassionate and caring staff. People had an opportunity to discuss their care and support on a regular basis. Advocate support was acquired if people needed support to express their views. People were shown respect and their dignity was protected always.

Care was planned and developed with people and their families. Systems were in place to monitor and address complaints. End of life care was developed, but staff required training in in this area.

There was a registered manager in post and they had clear oversight of the service, which they planned to develop further. However, staff rotas were not recorded. There was no future planning in place to monitor which staff were attending the care calls. Audits and quality checks were completed, but not always recorded. People were involved in discussions about their care and support. Staff felt supported by the registered manager and confident to raise issues and concerns. The registered manager was open and transparent with shortfalls in concerns we found during the inspection. The provider worked with other professionals and developed networks within the community.

Rating at last inspection: This is the first inspection since registration.

Why we inspected: This is a scheduled inspection based on the provider’s registration date.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit at the next scheduled inspection. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk