Violet Care Agency Ltd

Updated 19 August 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 3 inspectors and 2 Experts 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 houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there were two registered managers in post. The registered provider was also a registered manager. They are referred to in the report as ‘the provider’.

Notice of inspection

We gave the service 48 hours' notice of the inspection as we needed to be sure that the provider or registered manager would be in the office to support the inspection. Inspection activity started on 15 June 2023 and ended on 19 July 2023. We visited the location’s office on 20 June 2023.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We used information gathered as part of monitoring activity that took place on 1 November 2022 to help plan the inspection and inform our judgements.

We used all this information to plan our inspection.

The inspection

During our office visit we spoke with the provider, the registered manager, the in-house trainer and other office staff. We reviewed a range of records relating to the management of the service, including eight people's care records, four staff files, training and quality assurance records. We met, called or had email contact with 13 care staff. Outside of the office visit, the provider sent us additional information by email, as requested.

The experts by experience spoke with 16 people who use the service and 5 relatives to gather their feedback on the quality of care provided.

Updated 19 August 2023

About the service

Violet Care Agency Ltd – HSCA is a domiciliary care agency providing personal care to people in their own homes. At the time of inspection, the service was providing personal care to 187 people. This includes people being supported through the enablement service. This service provides time limited support to assist people coming out of hospital to regain as much of their independence as possible.

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

Feedback about the care provided from people and their representatives was mixed. Some people told us the care they received was not of the required standard, especially when they joined the service. Other people told us they received good care once they had settled into the service and had regular care staff.

The provider had failed to manage risk when new people joined the service, in particular when they required emergency care. Systems to monitor call times and missed visits required improvement. The provider had not always ensured people’s needs were promptly assessed and staff allocated to new people had the necessary skills to meet complex needs. We received negative feedback from some professionals about staff skills and communication from the service.

The service had grown considerably in the last year. There were new staff and systems; however, this growth had not been effectively managed. Improved oversight was needed to ensure the provider understood any gaps and areas of risk. The provider was committed to resolving the issues raised at inspection and took prompt steps to address immediate concerns. They also told us they would become more involved to improve safety and increase their oversight of the service.

Care plans were detailed and personalised, however they were not always updated with information from reviews and from the new systems.

The service had enough safely recruited staff; however, improvements were needed with staff deployment to ensure people’s needs were met safely and in-line with their preferences. Staff were positive about the support they received and morale was good. The provider had a focus on nurturing and developing leaders in social care. They promoted reflection and learning.

There had been recent improvements to safeguarding practice and knowledge. The provider had recently made effective improvements following concerns raised about the administration of medicines. Staff minimised the risk of infection.

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 26 February 2019)

Why we inspected

This inspection was prompted by a review of the information we held about this service. The inspection was prompted in part by notification of an incident following which two people using the service sustained a serious injury. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk. This inspection examined those risks.

Enforcement and Recommendations

We have identified breaches in relation to governance and management of risk at this inspection.

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

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.