Profad Care Agency Limited

Updated 11 February 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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by 1 inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was not a registered manager in post. A new manager had been in post for 2 months and had submitted an application to register. We are currently assessing this application.

Notice of inspection

This inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

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. 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 spoke with 6 people who used the service and 8 relatives of people using the service, about their experience of the care provided. We spoke with 9 members of staff including the manager, a care co-ordinator, a regional manager, quality assurance manager and four care workers.

We reviewed a range of records. This included 7 people’s care records and multiple medication records. We looked at 4 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.

Updated 11 February 2023

About the service

Profad Care Agency Limited is a domiciliary care agency providing personal care to 25 people in their own houses and flats at the time of inspection.

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

The provider had not ensured effective oversight of the service to ensure improvement in people’s care and risks to people were mitigated.

The provider's systems and processes had not always ensured effective oversight of the safety and quality of the service.

We could not be assured people received their medicine as prescribed. There was inconsistent information recorded about dosage of medication. Improvements were required to ensure staff were up to date with the provider's required training and their competency was assessed.

Safe recruitment practices were not always in place. The provider failed to follow their own procedures for the safe recruitment of staff.

We were unable to confirm staff members stayed with individuals for the allotted period of time. People told us staff left early on numerous occasions.

Systems and processes were in place to protect people from the risk of abuse. Staff had a good understanding of how to keep people safe and how and to report concerns. The provider and manager promoted a positive culture that supported choice and independence as much as possible. People’s social, cultural and religious needs were met.

The management team worked in partnership with other professionals to ensure good outcomes for people.

People, relatives and staff were invited to give feedback on care which was reviewed by the manager and monitored for themes. Staff received regular supervision and appraisal and felt well supported by the new manager.

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 requires improvement (published 21 July 2021). At this inspection we found the provider remained in breach of regulations and the service remains rated requires improvement. This service has been rated requires improvement for the last 3 consecutive inspections.

At our last inspection we recommended that staff files were reviewed, and risk assessments were implemented for any health conditions that may affect how staff can work. We recommended call times were reviewed and monitored to ensure people received care in a timely manner. At this inspection we found the provider had initially acted on the recommendations; however, they had failed to sustain the improvements.

At our last inspection we recommended complaints received were reviewed and responded to in line with the duty of candour. We saw this had taken place and the improvement had been sustained.

Why we inspected

We undertook this focused inspection to check whether the warning notice we previously served in relation to regulations 12 (safe care and treatment) and 17 (good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this report.

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 remained 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 Profad Care Agency Limited on our website at www.cqc.org.uk

Enforcement and Recommendations

We have identified 2 continued breaches in relation to safety monitoring and managerial oversight of the safety and quality of the service at this inspection.

You can see what action we have asked the provider to take at the end of this full 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.

Special measures

The overall rating for this service is requires improvement. The rating for well-led continues to be 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.