17 October 2022
During an inspection looking at part of 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.