Background to this inspection
Updated
1 December 2021
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 Care Act 2014.
Inspection team
The inspection was undertaken by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
The service had two managers registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
The inspection was unannounced.
Inspection activity started on 09 November 2021 and ended on 16 November 2021. We visited the office location on 09 November 2021.
What we did before the inspection
We reviewed all the information we held about the service since the last inspection. We also obtained information about the service from local authorities and local safeguarding teams.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke over the telephone with a total of 14 people who used the service and their family members about their experience of the care provided. We spoke with both registered managers (one is also the nominated individual), the branch manager, provider and 12 staff including care workers and office-based staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included 10 people’s care and medication records. We looked at recruitment records for five staff employed since the last inspection.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. A variety of records relating to the management of the service, including policies and procedures were also reviewed.
Updated
1 December 2021
About the service
Yes Care Services is a domiciliary care service that provides support and personal care to people in their own homes. Not everyone who used the service received personal care. The Care Quality Commission (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 107 people were receiving support with personal care.
People’s experience of using this service and what we found
Risks to people were assessed, monitored and managed. There were clear plans in place to guide staff on how to manage risks relating to the health, safety and welfare of people. Risks were regularly reviewed, and plans were updated to reflect any changes.
Staff followed safe infection prevention and control (IPC) measures. They used and disposed of PPE safely to minimise the spread of infection. People told us staff kept their homes clean and hygienic.
The recruitment of staff was safe. The required pre-employment checks were obtained to assess the fitness and suitability of applicants prior to a job offer being made. A risk assessment was carried out and monitored for staff where it was required.
People received care and support by the right amount of suitably qualified and experienced staff. Staff arrived at people’s homes on time and stayed for the full duration of the agreed call time. People told us they were contacted to let them know when a visit was running late.
Medication administration records (MARs) were completed to accurately reflect people’s prescribed medicines and how and when they should be administered. The alert system used to monitor the administration of medication was used effectively in identifying and actioning any medication errors or omissions.
Since the last inspection the leadership of the service had been strengthened by the appointment of a second manager to work alongside the current management team. The manager appointed was also appointed as the Nominated Individual (NI) with responsibilities for supervising the management of the service on behalf of the provider.
Governance systems were reviewed and strengthened to make sure they were effective. Managers and staff with responsibilities for completing audits and checks across the service received further training and support to increase their knowledge and confidence. Audits and checks were carried out consistently and used to drive improvement to the quality and safety of the service.
The culture of the service had improved which led to positive outcomes for people using the service. There were effective lines of communication with people, family members, staff and other partner agencies.
For more details, please see the full report for 'Yes Care Services' which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was inadequate (published 30 March 2021). At the last inspection, significant breaches of Regulations 12 (Safe care and treatment), 13 (Safeguarding service users from abuse and improper treatment) 17 (Good Governance) and 19 (Fit and Proper Persons) were identified. The service was placed in Special Measures.
At this inspection, the service has improved to requires improvement. Improvements were found across the service and the provider was no longer in breach of Regulations 12 (Safe care and treatment), 13 (Safeguarding service users from abuse and improper treatment) 17 (Good Governance) and 19 (Fit and Proper Persons). However, improvements made needed to be embedded and sustained over a longer period to achieve a rating of good.
This service has been in Special Measures since March 2021. During this inspection, the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
We undertook this focused inspection to follow up on the action we told the provider to take at the last inspection and to check whether the provider was compliant with the health and social care regulations for the key questions Safe and Well-led.
The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.
For more details, please see the full report which is on the CQC website at www.cqc.org.
Follow up
We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.