31 October 2022
During a routine inspection
Jiddak Limited is a domiciliary care agency providing personal care to people living in their own homes in the community. The service provides support to older and younger people with dementia or mental health issues, people with complex health needs and to those who may have physical or sensory disabilities. They were also supporting people who had a learning disability and autism. At the time of our inspection there were 34 people using the service.
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. The provider told us a different number of people were in receipt of personal care throughout the inspection and were unable to tell us an exact number.
People’s experience of using this service and what we found
People were at risk of harm because there was not sufficient guidance to inform staff how best to provide support. Medicines were not managed safely. People were not protected from the risk of abuse and had been harmed. The deployment of staff put people at risk and was not safe, the registered providers system for monitoring staffing was ineffective. Staff were not recruited safely, well managed or supported and their competency was not checked to ensure people received safe care and treatment. There were no systems in place to learn from accidents or incidents.
People were not assessed prior to them being supported by Jiddak Limited, which meant there were no assurances people’s needs could be met by staff. The provider and registered manager had poor oversight around the training needs of staff, they could not provide assurances staff had specialised training to support people with complex needs.
People were not treated with dignity and respect, language used in their care plans was derogatory. Equality, diversity and the individual needs of people had not been well considered.
Some people did not have a care plan, some documentation used disrespectful language which was not person centred or empowering. Complaints were poorly managed. People did not have end of life information in their care plans although some staff had received training in this area.
A positive culture was not promoted, and people were not treated with respect. The providers oversight of the service was poor, they did not oversee or assess the quality of the service they delivered. The provider and registered manager did not identify when things had gone wrong or taken action to learn from those errors. The provider and registered manager were not open and honest when things went wrong and did not understand their regulatory responsibilities as registered persons. The registered manager and provider did not always work well with other health care professionals or act in response to the concerns they raised. The registered manager and provider had failed to notify other professionals about incidents that should have been reported.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Right Support: Staff did not support people to play an active role in maintaining their own health and wellbeing. The service did not support people to have the maximum possible choice, control and independence over their own lives.
Right Care: People did not receive kind and compassionate care. Staff did not protect and respect people’s dignity. They did not understand or respond to their individual needs. Staff did not assess risks people might face. Where appropriate, staff did not encourage and enable people to take positive risks.
Right Culture: People did not lead inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. The service did not enable people and those important to them to work with staff to develop the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
This service was registered with us on 01 October 2020 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service. We received concerns in relation to management and oversight of the service. As a result, we undertook a comprehensive inspection to review all key questions.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.
We have identified breaches in relation to managing risks to people, safeguarding people from harm, staffing, poor recruitment, person centred care and lack of governance systems at this inspection.
Following the inspection, we took immediate action to restrict admissions to Jiddak Limited. We took urgent enforcement action and suspended the registration as a service provider in respect of the regulated activity of personal care. The provider de-registered Jiddak Limited with the Care Quality Commission and is no longer a registered service.