Archived: Niche Care Kirklees

Niche Care Kirklees is a domiciliary care agency providing personal care to people living in their own homes. At the time of our inspection there were 27 people using the service.

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

Risks to people were effectively assessed and managed. Medicines were managed safely. Accidents and incidents were reported, and people were safeguarded from the risk of abuse.

Safe recruitment procedures were in place and there were enough staff to meet people’s needs. Systems and processes were in place to support effective infection prevention and control.

The provider engaged with people and staff and acted upon feedback. People spoke positively about the care and support they received.

The manager was open and honest when things went wrong, and lessons learned were shared with staff. Quality assurance processes were effective in monitoring the service and making improvements.

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 08 February 2023) and there were 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 regulations.

Why we inspected

We carried out an announced focused inspection of this service on 18 October 2022 and 14 November 2022. 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, staffing and governance.

We undertook this focused inspection 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 which contain those requirements.

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 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 Niche Care Kirklees on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Niche Care Kirklees is a domiciliary care agency providing personal care to people living in their own homes. At the time of our inspection there were 40 people using the service.

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

People did not receive safe care. The support people received was not in-line with their needs. Staff did not have enough time to carry out calls to people. The time allocated to staff to travel to people was insufficient. Medicines were not administered as prescribed.

The manager did not have sufficient oversight of the service. Quality monitoring systems were inadequate, this led to repeated incidents occurring. Audits had not highlighted where improvements needed to be made. A system to learn lessons was not in place. Complaints of a similar nature had been raised. Feedback was not regularly sought and it was not used to drive improvement.

Staff were recruited safely. Staff understood how to safeguard people from the risks of abuse, however the systems in place to support safeguarding were not safe. Good infection prevention and control procedures were in place. Care plans and risk assessments were up to date and included personalised information.

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 02 June 2021). 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 the provider remained in breach of regulations.

Why we inspected

We received concerns in relation to the quality of care received by people. 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 requires improvement to inadequate based on the findings of this inspection.

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

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified continued breaches in relation to the safe management of medicines, receiving safe care and good governance at this inspection.

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.

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.

Niche Care Kirklees is a domiciliary care provider based in Huddersfield, and provides personal care to adults and older people in their own homes. At the time of our inspection the service supported 41 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 and what we found

People’s visit times were not always reliable or consistent. Staff were not allocated enough time to travel between visits and this meant visits were often too late for people’s care and support needs to be met properly.

There were enough staff, although they were not deployed effectively to enable people’s visits to be on time. Recruitment procedures were not robustly followed, which meant staff had not always been safely checked to ensure they were suitable to care for people.

People were not always supported to receive their medicines when they needed them and recording of medicines was not robust.

People and relatives gave positive feedback overall about staff who delivered the care, although they were not all assured the management of the service was good enough.

Care plans were not accurate as some individual risks were not identified or mitigated. There was a lack of person-centred care and people were not always supported in line with their needs.

There were weaknesses in the leadership and management of the service. There was a registered manager who was working alongside a new manager to enable them to take over the day to day running of the service.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 3 August 2020 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about people’s calls being late or missed, people receiving unsafe care and a lack of effective management of the service. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the all sections of this full report.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to people receiving appropriate, safe and reliable care, safe recruitment procedures and weaknesses in the management of the service, at this inspection.

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 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.