Kare Plus Oxford

Updated 12 August 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 was completed by 1 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.

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 not a registered manager in post.

Notice of inspection

We gave the service notice of the inspection. This was because the service is small, and people are often out, and we wanted to be sure there would be people at home to speak with us.

Inspection activity started on 12 July 2023 and ended on 20 July 2023. We visited the location’s office on 12 July 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. We used the information the provider sent us in the provider information return (PIR). 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 reviewed a range of records. This included 3 people’s care records and medicine records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

We spoke with 4 people and 4 relatives of people who used the service about their experience of the care provided. We spoke with 7 members of staff including the manager and care workers.

Updated 12 August 2023

Kare Plus Oxford is a domiciliary care agency. They provide 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 the inspection 15 people were receiving personal care.

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

Risks to people had not always been fully assessed or strategies recorded to reduce the risk of harm. Staff did not always have sufficient information or the skills and knowledge to support people safely. Training records did not evidence staff had received adequate training on people’s specific needs.

When people sustained an injury, records were not always clear on how the injury occurred, the size, shape or colour of injury or when the injury had healed. Investigations for incidents or accidents were not consistently in place.

People did not always know which staff were supporting them for each visit, staff did not always turn up on time or stay the allocated amount of time. However, people stated staff were kind and caring. Staff recruitment required improvement to ensure all necessary checks had been completed before staff worked with people. Policies and procedures were in place but had not been consistently followed.

Medicine management required improvement. Although we found no risk of harm, records were not consistently completed to ensure medicines were given as prescribed.

Systems and processes to ensure good oversight of the service, to identify concerns and make improvements were not effective or embedded into practice. Issues found on inspection had not been identified previously by the provider's own audits or reviews.

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 did not always support this practice.

Staff felt supported by the manager. However, regular meetings were not held to discuss concerns, make suggestions or share information. Not all staff had received a spot check to check if staff were working in a safe, person-centred way or if they were following policies and procedures.

Relatives were kept up to date on any changes in people's need, incidents or accident that occurred. Staff supported people to access healthcare support if needed.

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 8 June 2022)

Why we inspected

We received concerns in relation to management oversight and staffing. 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.

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

Enforcement and Recommendations

We have identified breaches in relation to risk management and oversight 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.