Archived: Executive Care Agency Limited

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

A new risk assessment process had been introduced. However, not everyone’s information or risk assessments had been updated although the provider was working to address this. People were cared for by staff in a way that kept them safe and protected them from avoidable harm. People were supported by enough staff who were available to respond to their needs in a timely manner. People received their medicines when they needed them, and systems were in place to ensure the administration of medicines was audited. However, not all staff members had received an assessment of competency to ensure they were safe to support people. Accidents and incidents were investigated, and measures were taken to prevent re-occurrences. Staff knew and followed infection control principles. We saw positive feedback about the quality of care. There were effective governance systems in place to monitor the quality of service and the health, safety and welfare of people. However, these systems have been newly introduced and need to be embedded into practice and sustained over time.

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

The last rating for this service was inadequate (published 8th May 2020) 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 some of the regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 9th March 2020. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, failure to comply with a condition, need for consent, good governance, fit and proper persons employed and staffing.

We undertook this focused inspection due to concerns about staffing and the management of the service and to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led.

The ratings from the previous comprehensive inspection for the other key questions were not looked at on this occasion but were used in calculating the overall rating at this inspection. The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.

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

Follow up

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

Executive Care Agency is a domiciliary care service that provides personal care to people living in their own homes. At the time of our inspection visit, the service was providing personal care support to 20 people.

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

Systems were not in place to effectively monitor the quality and safety of the service. The provider had failed to comply with conditions on their registration and had not informed us of moving locations. People’s care was not being regularly checked and reviewed to ensure guidance was in place for staff and that risks were assessed and planned for. The provider had failed to ensure they had gathered enough evidence to assure themselves that staff were of fit and proper character to support people who used the service. There were staffing difficulties meaning management staff were having to cover calls. Risks were not always assessed and planned for to keep people safe. Medicines were not always safely managed. Lessons were not always learned when things had gone wrong. We could not be confident all safeguarding concerns would be identified as not all staff knew the different types of abuse, signs to look out for or how to report to the local safeguarding authority. There was mixed feedback about infection control measures. Robust plans were not in place to ensure the service could continue to operate in emergency situations, although our feedback was acted upon in relation to this.

People did not have their decision-specific capacity assessed, relative or representative’s legal right to make decisions on behalf of people had not been verified and decisions taken in people’s best interest were not recorded. Staff did not have sufficient training or support to feel confident in their role. Plans of care were not always in place for specific health conditions, although people had access to other health professionals. People were supported to have enough to eat and drink.

Plans were not consistently completed to ensure there was enough information for staff and staff feedback confirmed this, however people generally saw the same staff who they got to know. End of life plans were not in place, but the registered manager was aware of their responsibility to support people appropriately at the end of their life. People felt able to complain and their queries were resolved. People were supported to access information and communicate in a way that suited them.

As there were not always enough checks and systems in place to always keep people safe, and staff did not always have enough training which was not caring for people. Despite this, people and relatives felt positively about the staff who supported them. People were supported to make decisions, were treated with dignity and respect and could remain independent where possible.

Staff did not always feel supported in their role. People, relatives and staff were not actively engaged in the service. There was no evidence that people’s protected characteristics had always been taken into account. People and relatives felt positively about the management team and felt able to approach them, 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

This service was registered with us on 12 April 2019 and this is the first inspection.

Why we inspected

This was a planned inspection based on the date of registration. However, it was brought forward due to the number of whistleblowing concerns we had received about the service. Concerns raised to us included lack of training, lack of sufficient recruitment checks and poor management.

Enforcement

We have identified breaches of regulation in relation to recruitment, safe care and treatment, checking people’s consent, staff training, oversight of the service and the provider breaching a condition of their registration with the CQC.

You can see the action we told provider to take at the end of the full report.

Follow up

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Special Measures

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.