10 January 2023
During an inspection looking at part of the service
Excel Care Management Services is a domiciliary care service located in Wigan. It provides personal care to people living in their own houses and flats. Not all people using the service were receiving a regulated activity. 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
Medicines were not always managed safely, and some people did not receive them as prescribed. Although staff were recruited safely. DBS risk assessments were not always completed appropriately. Some people who used the service and relatives said personal protective equipment (PPE) was not always worn by staff when delivering their care. There were enough staff working for the service, although some people raised concerns with us about the timeliness of their care visits during the day. We have therefore made a recommendation regarding staffing levels.
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 this practice.
There were limited governance systems in place at the time of our inspection and the service were unable to evidence audits, spot checks and competency assessments were carried out consistently for all staff. There was mixed feedback about management and leadership and not all staff said they felt there was a positive culture within the service.
Rating at last inspection
The last rating for this service was good (published July 2018).
Why we inspected
The inspection was prompted in part due to concerns received about recruitment of staff, medication, staffing and leadership. A decision was made for us to inspect and examine those risks.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed to requires improvement based on the findings at this inspection. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Excel Care Management on our website at www.cqc.org.uk.
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 safe care and treatment and good governance. We will continue to monitor the service and will take further action if needed.
You can see what action we have asked the provider to take at the end of this full report
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect. For more details, please see the full report which is on the CQC website at www.cqc.org.uk