About the service A50 is a domiciliary care agency providing personal and nursing care people in their own homes. The service provides support to children and older people, some of which have a physical disability. At the time of our inspection there were five 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.
People’s experience of using this service and what we found
People did not receive support from a safe service. People’s identified risks were not always recorded with clear guidance for staff to follow to mitigate the risks. People’s medicines were not always recorded in line with good practice. The registered manager failed to ensure robust pre-employment checks were undertaken prior to staff working at the service. The registered manager failed to ensure lessons were learned when things went wrong.
People did not receive support from a service that was always effective. Staff members were not supported to have one-to-one supervisions with the registered manager to reflect on their working practices. People's nutritional and hydration needs were not always recorded and guidance for staff on how to support them was not clearly documented. The registered manager failed to comprehensively record people’s assessed needs prior to them using the service.
People did not have their personalised needs and preferences recorded in their care plans. People's communication needs were not always documented.
There were no systems in place to ensure the governance and monitoring of the service were robustly carried out to drive improvements. People did not always receive a service that had an embedded culture that learned and improved the service delivery. The registered manager failed to ensure records were kept in line with legislation.
Staff had a clear understanding of identifying, reporting and escalating suspected abuse. People told us staff arrived on time for their visit and always stayed the duration of the call. People were protected against the risk of cross contamination as the registered manager had effective COVID-19 protocols in place.
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 support this practice.
People received care and support from staff that demonstrated compassion and empathy. People’s privacy and dignity were maintained and where possible people were encouraged to maintain their independence.
People’s relatives and staff spoke positively about the service, stating the registered manager was approachable and supportive. People’s views were sought to drive improvements. The registered manager worked in partnership with healthcare professionals to enhance people’s lives.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 23 December 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.
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 will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to medicines and good governance at this inspection. We have made a recommendation in relation to preadmission assessments.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
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.