The Care Quality Commission (CQC) has dropped the rating for Access Dignity Care Limited from good to inadequate following an assessment in January. The CQC have also placed conditions on their registration, which require them to make immediate improvements and update CQC monthly on the progress of these.
Access Dignity Care Limited, run by a company of the same name, is an agency providing personal care to people in their own homes. The service was supporting 68 people at the time of our inspection, including older people, people living with dementia, and people with mental health needs or a physical disability. The service is also registered to care for autistic people and people with a learning disability, but none were receiving CQC-regulated care at the time of this inspection.
This inspection was prompted by safety concerns people raised to CQC.
As well as dropping from good to inadequate overall, so have the service’s ratings for safe and well-led. Its rating has dropped from good to requires improvement for effective. Its rating has dropped from outstanding to requires improvement for being caring. The service’s rating for responsive was only partially inspected, so this remains rated good from a previous inspection.
Hazel Roberts, CQC deputy director of operations in the East of England, said:
“We found the service wasn’t always giving people safe and compassionate care because they didn’t always understand people’s individual needs. Leaders hadn’t fixed this because they didn’t have oversight of people’s care and didn’t always understand their responsibilities.
“Leaders hadn’t given staff the training or support to provide safe care, and some people told us they didn’t always feel confident staff knew how to meet their needs. Although people said their regular care workers were kind, we saw staff weren’t knowledgeable about people’s health conditions or preferences, in part because some people’s care records were incomplete or inaccurate.
“Leaders also weren’t always responding quickly when things went wrong. In one incident, staff provided poor first aid when someone was burnt and needed an ambulance, causing avoidable pain and discomfort. But leaders didn’t formally investigate the incident or raise a safeguarding alert to the local authority. This meant people weren’t protected from this happening again in future.
“We shared our findings with the service after this inspection, and leaders were responsive to our feedback. We’ve placed conditions on the service’s registration to ensure improvements are made quickly, and we’ll be monitoring the service very closely to ensure people are receiving safe care while this happens.”
Inspectors also found:
- Leaders didn’t always act quickly on known risks to people’s safety. In one case, a person who needed help to eat and drink wasn’t getting this help from staff. Leaders confirmed they knew about the issue but hadn’t taken any action, which risked this person going without food and drink
- The service’s safeguarding systems to protect people from risks of abuse weren’t effective. Staff didn’t know how to escalate safeguarding concerns to outside authorities
- The service didn’t involve people in planning their care. Many people said visit times were inconvenient to them and they weren’t always cared for by staff of the gender they requested. Some people had refused care because their preferences weren’t respected, and the service hadn’t always responded appropriately in cases where this could put people’s health at risk
- Staff and leaders didn’t always understand how to seek people’s consent, or how to care safely for people who didn’t have the capacity to consent, which impacts on their human rights
- Leaders didn’t ensure people could always communicate their needs. Some staff struggled to communicate with people because they spoke different languages
- Due to staffing issues, people weren’t always cared for by staff who knew them well
- Staff didn’t support people to be as independent as possible and didn’t always know people’s goals, interests, or hobbies
- Leaders had failed to make statutory notifications to CQC about abuse or serious injuries as required by law, which are required to ensure CQC can monitor for any risks or concerns about the service.