Background to this inspection
Updated
13 October 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service is not required to have a registered manager. The provider carried out this role.
Notice of inspection
We gave the service three days notice of the inspection. This was because it is a small service and we needed to be sure that the provider would be in the office to support the inspection.
What we did before the inspection
Before the inspection we reviewed information we held about the service and the provider which included statutory notifications sent to the CQC. A notification is information about important events which the service is required to send us by law.
We used the information the provider sent us in the provider information return. This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We also used information provided by the local authority Quality Assurance team. We used all of this information to plan our inspection.
During the inspection
Inspection activity started on 22 September 2022 and ended on 27 September 2022. We spoke with people, relatives and staff on the phone on 22 September 2022. We visited the office location on 26 and 27 September 2022.
We reviewed five care plans and risk assessments. We looked at medicine administration records. We looked at three staff files in relation to recruitment. Staff training and supervision records were reviewed. We looked at other records relating to the management of the service, including complaints records and audits. We spoke with eight staff including the provider, deputy manager and administrator. We spoke with 18 people and nine relatives of people who were receiving personal care and support about their experiences of the service provided.
Updated
13 October 2022
About the service
Faith IN ME homecare is a domiciliary care agency. The service provides personal care and support to 57 people. At the time of our inspection there were 64 people using the service.
Not everyone who used the service received personal care. In this service, the Care Quality Commission can only inspect the service received by people who get support with personal care. This includes help with tasks related to personal hygiene and eating. Where people receive such support, we also consider any wider social care provided.
People’s experience of using this service and what we found
Risks were not always assessed, monitored or reviewed which did not reduce the risk of avoidable harm. Where we identified some risk assessments were missing from some care plans, we asked the provider to complete them immediately. Staff did not follow the service policy when supporting people with their finances.
The service was fully staffed at the time of the inspection. However, frequent short notice sickness absence was requiring the management team to cover visits on a regular basis. Recruitment processes were not always robust. This did not ensure that all staff were safe to work alone with vulnerable people.
Care plans did not always contain accurate information. Some information was out of date such as referring to previous accommodation issues when the person had moved house. Care plans did not always contain sufficient guidance and direction for staff.
People were supported by staff who had mostly been appropriately trained and were skilled in their role. Some staff needed to complete required training. Staff told us they were regularly supported through supervision and informal meetings at people’s homes. However, the records held by the provider showed that supervision was not being provided in accordance with the policy held by the service.
The provider did not have effective quality assurance systems in place to monitor the quality and safety of the care provided. Spot checks were carried out to monitor staff performance and people were asked for their views and their suggestions were used to improve the service and make any necessary changes. However, the provider told us they did not have the time to monitor care plans, risk assessments, medicine records, or recruitment processes.
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.
People and their relatives spoke positively about staff and told us they were happy with the service they received. People told us staff were friendly, they were treated with kindness and compassion and their privacy and dignity was respected.
People told us they felt safe with staff. There were systems to help protect people from abuse and to investigate any allegations, incidents or accidents.
Assessments of people's care and support needs were carried out before they started using the service. People received support to maintain good health and were supported to maintain a balanced diet where this was part of their plan of care.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk
This is the first inspection of this newly registered service.
Why we inspected
We were prompted to carry out this inspection due to concerns we received about poor management processes, low staffing, poor staff training and support and staff behaviour. A decision was made for us to inspect and examine those risks.
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 found breaches in relation to the management of risk, poor management oversight, inaccurate and incomplete records, staff recruitment and a lack of person-centred support at this inspection.
Please see the action we have told the provider to take at the end of the full version of this report.
Follow up
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.