Background to this inspection
Updated
8 July 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
An inspector and a specialist advisor visited the service on the first day. Two Expert by Experience made phone calls to people and their relatives to seek their views about the service. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. Two inspectors returned to the service on the second day to complete the inspection.
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 was a registered manager in post.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or the registered manager would be in the office to support the inspection.
Inspection activity started on 16 March 2023 and ended on 03 April 2023. We visited the location’s office on 21 and 29 March 2023.
What we did before the inspection
Before the inspection we reviewed the information we held about the service. This included details about incidents the provider must tell us about, such as any safeguarding alerts that had been raised. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. This information helps support our inspections. We sought feedback from commissioners and the local authority safeguarding team. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.
During the inspection
We spoke with 10 people who used the service and their 16 relatives about their experience of the care provided. We spoke with 10 members of care staff, 5 office-based staff, the registered manager, and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records. This included 16866 calls for 153 people for the period 20/02/2023 to 20/03/2023(29 days), 12 people’s care records, 11 staff recruitment records and a variety of records relating to the management of the service, including management of medicines, policies, and procedures.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at a range of records related to staff training and deployment, care plans and care logs, and quality assurance records were also reviewed.
Updated
8 July 2023
About the service
Capital Homecare (UK) Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is to help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection, 207 people were using the service.
People’s experience of using this service:
Some people were not supported by effectively deployed staff to keep people safe and to meet their needs in a timely manner. The quality assurance system was not robust; as the provider had not always identified some of the issues we found at this inspection, in relation to staff deployment, late calls, call monitoring and management of people’s medicines about recording.
At our last inspection we recommended the provider giving sufficient care tasks details and guidance for staff in the care plan, alongside people’s choices and preferences. At this inspection we found the provider had made sufficient improvements. Staff showed an understanding of equality and diversity. Staff respected people’s choices and preferences. People knew how to make a complaint. The registered manager knew what to do if someone required end-of life care.
People and their relatives gave us positive feedback about their safety and told us staff treated them well. People were protected from the risk of infection. Staff received support through training, supervision and staff meetings to ensure they could meet people’s needs. Staff told us they felt supported and could approach the management team members at any time for support.
Staff asked for people’s consent, where they had the capacity to consent to their care. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
An assessment of people’s needs had been completed to ensure these could be met by staff. People and their relatives were involved in making decisions about their care and support. People were treated with dignity, and their privacy was respected, and supported to be as independent in their care as possible.
There was a management structure at the service and staff were aware of the roles of the management team. They told us the registered manager was supportive and approachable.
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 requires improvement (published 01 October 2021). At that inspection we found breach of regulation in relation to good governance. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made in relation to detailed care plans with sufficient guidance for staff. However, we found the provider was in breach of regulation 18 and remained in breach of regulation 17. The service remains rated requires improvement. This service has been rated requires improvement for the last 2 consecutive inspections.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement and Recommendations
We have identified breaches in relation to staffing and good governance. At our last inspection we recommended that the provider keeps a record for administration of PRN (as required) medicine on each occurrence where a member of staff has supported with its use. At this inspection we found the provider had not made sufficient improvements.
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.