Archived: YES Care Services - Knowsley

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.

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. 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 200 people were receiving support with personal care.

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

Risks to people's health, safety and welfare were not assessed, monitored and managed. This put people at risk of unsafe care. Risk assessments had not been fully completed and carried out in response to people’s changing needs.

People told us staff failed to follow safe infection prevention and control measures putting people at risk of infection. Staff were provided with the right personal protective equipment but failed to use it correctly.

Safe recruitment processes were not followed. The required checks were not carried out for staff employed in order to assess their fitness and suitability to work with people using the service.

Staff did not attend visits to people’s home at the right times and stay for a sufficient duration of the planned visit. This impacted on the quality of care people received.

Medicines were not safely managed. Medication administration records (MARs) were not signed to show people had received their medicines as prescribed and they were not updated to reflect changes to people’s medicines. There was a failure by the registered manager to ensure safe systems for the management of medicines.

The provider and registered manager failed to have oversight of the systems in place to ensure people received safe and effective care. They failed to identify and mitigate the risks we found during the inspection. The failure to monitor visit times led to people not always receiving person centred care with good outcomes. Some people were not provided with information about the level of care and support the service was required to provide and their views about the service were not always obtained.

The provider and registered manager took immediate action during and after the inspection to make improvements. They are also working closely with the relevant local authorities who are monitoring and supporting 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 good (published 21 January 2020).

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for YES Care Services ' our website at www.cqc.org.uk.

Why we inspected

CQC received information about an incident which indicated concerns about people’s safety and the management of the service. This inspection examined those risks. Please see full details in the individual sections of this full report.

Enforcement

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.

We have identified breaches in relation to risk management, the management of medicines, safeguarding, staffing and recruitment and the governance of the service.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Yes Care Services is a domiciliary care service that provides support and personal care to older people 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 79 people were receiving support with personal care.

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

People and family members felt that on-the-whole the service was well-managed. However, some felt that better organisation was needed to support care staff within their role. Some people and family members felt staff appeared rushed and told us there were often new staff being recruited and regular staff were often leaving. Staff felt supported in their role and keen to implement the person-centred culture and approach encouraged by the registered manager and provider. Effective quality assurance systems were in place to monitor key aspects of the service.

People told us they felt they received care from staff that made them feel safe and were confident they were well looked after. Staff showed a good understanding of their roles and responsibilities of keeping people safe from harm. Risks to people had been assessed and those identified were managed safely by competent staff. Where people required support with medication this was managed safely; people and family members confirmed that medication was received at the right times. Where required, people had access to appropriate equipment and were supported to ensure their homes remained safe.

Sufficient numbers of suitably qualified and skilled staff were deployed to meet people’s individual needs. Staff had received a range of training and support to enable them to carry out their role safely and effectively. People told us they received the right care and support from staff who were well trained and knew them well. People also told us staff never missed a call and always arrived on time.

People’s needs and choices were assessed and planned for. Care plans identified intended outcomes for people and how they were to be met in a way they preferred. People received support to maintain good food and drink intake and their healthcare needs were understood and met. Care was delivered in a personalised way and in line with information recorded in people’s care plans.

Staff delivered care in a person-centred way based on people’s preferences and likes. People and family members told us staff were kind and caring and always treated then with respect. People felt listened to and told us staff had time to sit and chat with them. People were supported to maintain relationships with family members and to access community activities to reduce social isolation.

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.

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

Rating at last inspection and update: This was the first inspection since this service was registered in November 2018.

Why we inspected

This was a planned inspection based on the date of registration.

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.