Fuchsia Homecare Colchester

Fuchsia Homecare Colchester is a domiciliary care agency providing personal care to people living in their own homes. 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. At the time of our inspection there were 96 people receiving personal care support.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

People’s experience of using this service and what we found

The provider’s processes for reviewing the quality and safety of people’s care were not always robust. People’s care visits were not taking place at the agreed times or for the agreed duration. We were not assured the provider had always ensured there were enough staff available to meet people’s needs and preferences. People’s feedback had not always been used to develop and improve the care provided.

Risks to people’s safety were assessed; however, information was not always detailed. Staff knew how to recognise and report any concerns or signs of abuse and people told us they felt safe. The provider had processes in place to manage people’s medicines safely. Staff were safely recruited with appropriate employment checks completed.

People and relatives spoke positively about the care they received from staff and the approachability of the management team. Staff told us they felt supported and were able to contact the management team if they had any concerns. The provider worked in partnership with other health and social care professionals in order to meet people’s support needs.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 20 December 2019).

Why we inspected

We received concerns in relation to the quality and safety of people’s care, the provider’s safeguarding processes and management oversight at the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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 from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Fuchsia Homecare Colchester on our website at www.cqc.org.uk.

Enforcement

We have identified a breach in relation to the provider’s governance processes at this inspection. Please see the action we have told the provider to take at the end 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.

Fuchsia Homecare is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a personal care service to older adults, younger disabled adults, people living with dementia and mental health conditions. At the time of our inspection there were 62 people using the service across Essex and villages between Colchester to Ipswich.

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 the quality of the service had improved for people since the last inspection.

The service lacked a robust process for monitoring late and missed calls. We have made a recommendation

People capacity was assessed in line with national guidelines. However, assessments were not recorded to formalise outcomes, but staff understood people's capacity well

All known and expected risks in the service had been identified and mitigated. Staff were supported with best practice knowledge and information

Staff were recruited safely.

People's health was well managed, and relationships had been developed to ensure that individual health and nutritional needs were met.

People’s medicines were well managed, and people received them when they were required.

End of life care plans were not always in place for people. We have made a recommendation about this.

Improvements have been made to the oversight of the service.

Relatives and professionals made positive comments about the management team at the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 24 October 2018) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Fuchsia Homecare (Colchester) was first registered in April 2018. This was the first inspection of this service.

This service is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a personal care service to older adults, younger disabled adults, people living with dementia and mental health conditions. At the time of our inspection there were 49 people using the service across Essex and villages between Colchester to Ipswich.

The registered manager had recently left the service. A new manager had been appointed who told us they had submitted their application to register with the Care Quality Commission (CQC). A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were not always protected from the potential risk of harm and abuse. Some staff were unaware of the action to take if they suspected abuse. Potential risks posed to people had not been consistently assessed. Whistleblowing guidance was not always available to staff to inform them of the action required to mitigate the risk of harm.

Staff were not recruited safely in accordance with the provider's own policy and procedure. Safety and competence checks had not always been completed before staff were left unsupervised to care for people in their own homes.

Some people's care plans were detailed and gave staff guidance regarding how to meet people's needs. However, care plans were not always available in people’s homes to guide staff when the service started.

Staff had not always received the quality and range of training they required to meet people's needs and equip them for the role they were employed to perform.

People told us the staff were kind and caring and they were supported with dignity when receiving care and support. However, where staff did not have English as their first language people told us communication was challenging and staff did not always understand their needs.

The provider had some effective systems to monitor the quality and safety of the service provided to people but there was a need for further improvement. Surveys to assess people’s views were carried out. There was a complaints procedure in place, however this was not always being followed. The overall governance from the senior management team had not identified the shortfalls that were found during this inspection.

Systems were in place to audit people's medicine records on a monthly basis but did not include any check of stock. Guidance for staff was not always provided on medication administration records to ensure people received their medicines as prescribed.

Staff used personal protective equipment to safeguard themselves and people from the risks of infection.

There was a system in place to assess people’s views about the service provide. There was also a policy and procedure for receiving and handling complaints, however this was not always being followed.

People were supported to maintain their nutrition and hydration, if this was part of their package of care. People were supported to maintain their health with support from health care

professionals.

There were enough staff employed to meet people's needs. People were supported by regular members of care staff, providing continuity of care to people.

People were supported to have choice and control of their lives. However, the management team and staff lacked understanding as to their roles and responsibilities in relation to the Mental Capacity Act 2005.

During this inspection we identified breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the end of this report.