Background to this inspection
Updated
14 March 2023
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 team consisted of one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
Registered manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post. The registered manager was not available during this inspection, we spoke with the registered provider.
Notice of inspection
We gave the service 24 hours' notice of the inspection. This was because it is a small service and we needed to be sure that the manager would be in the office to support the inspection.
Inspection activity started on 25 November 2022 and ended on 19 January 2023. We visited the office location on 25 November 2022.
What we did before the inspection.
We reviewed the information about the service since they first registered. 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 used all this information to plan our inspection.
During the inspection
We spoke with 1 relative, about their experience of the care provided. We spoke with the Nominated individual who also provided the care to people. The nominated individual is responsible for supervising the management of the service on behalf of the registered provider.
We reviewed daily care records and policies and procedures. Despite various requests for documents/information to help with the inspection these have not be submitted by the registered manager or registered provider.
Updated
14 March 2023
About the service
Focus Care Professional Limited is a domiciliary care agency. It provides personal care and support to people living in their own homes.
Not everyone who used the service received personal care. At the time of this inspection 2 people were receiving personal care from the service. 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
Governance systems and processes were not fully established. We identified shortfalls in recruitment, medicine management, risk assessments, and overall management oversight of the service. Records of staff training and support were not provided, therefore we were not able to confirm staff had completed mandatory training as required. This put people at risk of harm and receiving unsafe care.
Safe recruitment practices were not always followed with appropriate checks not always being completed to ensure that only suitable staff were employed. People may have been placed at a risk of harm from staff members who had not been recruited safely. We could not be assured risk to people had been assessed and mitigated as risk assessments were not provided despite various requests to provide these.
Care plans were not person centred, incomplete and did not fully describe the care provided to people. Daily records did not describe the personal care provided to people. Relatives confirmed people’s needs were assessed, however, records of needs assessments were not provided despite several requests. People were protected from the risk of abuse because staff knew the action to take should they suspect or witness abuse.
Relatives told us they were happy with the care provided by staff and told us they felt involved in planning and organising the care.
Staff knew people well and delivered care and support to people in ways they preferred, respecting their choices and wishes.
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; however, were not able to confirm the policies and systems used to support this practice as these were not provided during this inspection.
The service involved people and their families with people's day to day care and support needs. Relatives told us they were listened to and were consulted about how their relative received care and support. Relatives told us the service was well led and staff were kind and caring.
Rating at last inspection
This service was registered with us on 12 December 2018 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement and recommendation
We have identified breaches in relation to recruitment, risk management, medicines, staff training and good governance.
We have made a recommendation in relation to needs assessments and recording of daily care notes.
Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
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.