16 February 2022
During a routine inspection
Paula Integrated Care is a domiciliary care service registered to support children and adults, including older people, people with a physical disability and people living with dementia. 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 our inspection, the service supported 29 people with personal care.
People’s experience of using this service and what we found
We found improvements were required with training documentation, supervision completion, topical medicines process, review process for accidents and incidents, care planning and the audit and governance process.
Staff supervision had not been provided in line with guidance, as not all staff had completed supervision sessions over the last 12 months. Staff told us they received enough training to carry out their roles, however, the documenting of training completion was disjointed. 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 supported this practice.
The majority of people, relatives and staff spoke positively about the management of the service and support provided. Although some audits had been used to monitor the quality and effectiveness of the service, there was not a clear schedule in place. Actions plans had been used to help drive improvement, however issues had either not been addressed timely or improvements sustained.
Care files contained mainly task based information about each person and how they wished to be supported, with limited information about people’s likes, dislikes and interests. Most of the people and relatives we spoke with had been involved in discussions around care planning. The complaints process was provided to people at the beginning of their care package. Each person or relative we spoke with knew how to formally raise concerns but had not needed to. Communication care plans explained people’s communication needs; however, we saw no evidence information was available in different formats.
We have made a recommendation around how information is provided to people.
People who received assistance to take their medicines, had no concerns with the support provided. From records viewed we could not be certain whether people required support with topical medicines and if so, if these had been applied. People confirmed staff wore PPE and staff told us specific COVID-19 training had been provided. However, recent guidance changes to the staff testing process had not been fully implemented.
We have made a recommendation about adhering to testing guidance.
People and relatives told us the service provided safe care and they felt comfortable in staff’s presence. Staff had received training in safeguarding and knew how to report any concerns. Overall, care visits were completed timely. However, travel time was not always included on the call planning system, which could have led to late visits.
We have made a recommendation about the call scheduling process.
People and relatives spoke positively of the care provided, which they said was delivered by staff who were kind, friendly and helpful. We were also told staff respected people’s privacy and dignity and offered them choice. People’s views were sought through care reviews and annual surveys, to ensure the service continued to meet their needs.
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 19 November 2020 and this is the first inspection.
Why we inspected
This was a planned inspection based on the date of registration in order to provide an initial rating for the service.
We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.