The Care Quality Commission (CQC) has rated Santos Care Limited, Wolverhampton, inadequate and placed it into special measures to protect people, following an inspection, in October.
This inspection was carried out to follow up on specific concerns it was told to address at its previous inspection including risk assessments and the safety of the service provided.
Santos Care Limited is a domiciliary care service that provides personal care in people’s homes. At the time of inspection, there were 15 people using the service.
Following this inspection, the service’s overall rating has dropped from requires improvement to inadequate, as have the ratings for being safe, effective and well-led. It has again been rated requires improvement for being responsive. Caring wasn’t rated on this occasion so remains requires improvement.
The service is now in special measures, which means it will be kept under close review by CQC to keep people safe and it will be monitored to check sufficient improvements have been made.
Andy Brand, CQC deputy director of operations in the midlands, said:
“When we visited Santos Care Limited, it was disappointing to see such a significant shortfall of strong leadership. We found leaders hadn’t implemented effective systems and processes to enable staff to deliver high-quality care for people using the service.
"Leaders had failed to take action to address the regulatory breaches we told them to address at their previous inspection. This meant people remained at risk of receiving unsafe and inconsistent care and support.
“We found that care plans and risk assessments still lacked detail staff needed to deliver safe care. Staff didn’t have access to the information they needed to mitigate people’s individual risks, sometimes in an emergency. For example, information to guide staff in how to keep one person using the service safe who sometimes needed emergency support wasn’t recorded, putting them at risk.
"People who received medications administration as part of their care call were potentially put at harm due to inconsistent care calls of varying length and were regularly late. There was no monitoring system in place and the provider hadn’t taken action to improve the issues.
“Additionally, staff couldn’t identify potential signs of abuse although they had received safeguarding training. They also didn’t complete records used to identify potential abuse or safety concerns. This meant that people could be at risk of abuse and opportunities to raise concerns were missed. Following our inspection, we made a safeguarding referral to the local authority that the staff and provider had not identified as a potential safeguarding incident.
“We have told Santos Care Limited where we expect to see rapid, widespread improvements and will continue to monitor them closely to keep people safe during this time. We will return to check on their progress and won’t hesitate to take further action if people are not receiving the care they have a right to expect.”
Inspectors found:
- Where people took medication, it was not clear who was responsible for the management and administration of medication
- The provider took no action and didn’t learn lessons when improvements were suggested regarding people’s care
- Nursing tasks been completed but no training in these areas had been provided
- People told inspectors staff were not always well trained although records indicated they had completed an induction and were up to date with training
- 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
- People's care plans were not always consistent and were not always reviewed when people's needs changed
- Staff did not always have sufficient English language skills to communicate effectively with people and their relatives which placed them at risk
- Complaints were not always managed and addressed consistently and feedback from relatives was not always taken on board.
However,
- Staff informed relatives where there were any health concerns
- People and relatives thought staff were kind and caring and treated them with respect
- Staff supported people to maintain their independence
- Staff told inspectors the registered manager was supportive and approachable.
The report will be published on CQC’s website in the next few days.