Immaculate Grace Care Ltd

Updated 10 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: One inspector, an assistant inspector and an expert by experience carried out the inspection. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.

Service and service type: Immaculate Grace Care Ltd is a domiciliary care agency. It provides personal care to people living in their own homes, including, older people and people living with dementia. CQC regulates the personal care provided.

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: This comprehensive inspection took place on 3 April 2019. The inspection was announced. We gave the service 48 hours' notice of the inspection because we needed to be sure the provider or registered manager and other staff would be available to speak with us.

Inspection activity started on 14 March 2019 and ended on the 3 April 2019 when we visited the office location to meet with the provider and the registered manager, speak with staff; and to review care records and policies and procedures.

What we did: Prior to the inspection, we looked at the information we held about the service and used this to help us plan our inspection. This included concerns and complaints we had received and information the provider must notify us about, such as allegations of abuse. We reviewed the 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 contacted the local authority commissioners for the service. The commissioners informed us that they were planning to cancel their contract with the provider. We also contacted the local Healthwatch. Healthwatch is an independent consumer organisation that promotes the views and experiences of people who use health and social care services. They had no information to share with us.

We spoke with the provider, who is also the Nominated Individual for the service, the registered manager, a care co-ordinator, the administration manager and two members of care staff. We also spoke with two people, and four relatives of people who used the service by telephone.

We reviewed a range of records. That included, three people’s care records, including risk assessments and medicine records. Two staff personnel files, including recruitment, induction and training records. Staff work programmes and allocation records. Records of complaints and management audits and checks.

Updated 10 May 2019

About the service: Immaculate Grace Care Ltd is a domiciliary care agency. It is registered to provide personal care to people in their own homes, including, older people, people with mental health problems, and people living with dementia. At the time of the inspection visit the service supported 19 people.

People’s experience of using this service:

• People had not always received visits from consistent staff, at the times arranged. People told us this had improved in the last few weeks.

• Staff understood how to keep people safe and protect them from avoidable harm.

• People’s needs were assessed to ensure they could be met by the service.

• Staff knew about the risks associated with people’s care, but management plans had not been completed for all identified risks.

• Staff were recruited safely, and there were enough staff to provide the care and support people required.

• There were safe procedures to manage people’s medicines and to prevent the spread of infection.

• Staff received training to be effective in their role. Some people had been concerned about the level of staff skills, but told us these had improved recently.

• There were processes to support staff, but these had not been implemented regularly.

• People made their own decisions about their care and were supported by staff who understood the principles of the Mental Capacity Act 2005.

• Staff were caring and respected people’s rights to privacy and dignity.

• People were involved in planning their care and were regularly consulted about the care provided,

• Care plans contained the information staff needed to provide personalised care.

• Systems were in place to manage and respond to any complaints or concerns raised, but how complaints were recorded needed improvement.

• The provider had processes for assessing and monitoring the quality of the service. Improvement was required to ensure effective oversight of the service.

Rating at last inspection: Requires Improvement. The last inspection report was published on 18 May 2018.

Why we inspected: This was a planned inspection based on the date and the rating of the previous inspection. We had also received concerns about the service that we had referred to the local authority and to the provider to investigate which we needed to review. The overall rating for the service has not changed and remains requires improvement.

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

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