Caring for You

Updated 26 May 2022

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.

Inspection team

The inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

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

The service is not required to have a manager registered with the Care Quality Commission because the registered provider runs the service. This means the registered provider is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 9 March 2022 and ended on 31 March 2022. We visited the location’s office on 9 March 2022 and made telephone calls to people and relatives on 18 March 2022.

What we did before the inspection

We reviewed the information we had received about the service since the last inspection. We sought feedback from the local authority and partner agencies.

The provider did not complete the required Provider Information Return (PIR). This is information providers are required to send us annually with key information about the service, what it does well and improvements they plan to make.

We used all this information to plan our inspection.

During the inspection

We spoke with five people who used the service and five relatives on the telephone, about their experience of care provided. We spoke with the registered provider who was also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with a part-time consultant and one of the care managers on site, and a further six members of staff by telephone. We reviewed a range of records, including three people's care records. We looked at three staff files in relation to recruitment. We reviewed records relating to the management of the service, including policies and procedures.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at staff recruitment and training data, policies and procedures and requested further information in relation to the running of the service.

Updated 26 May 2022

About the service

Caring for You is a domiciliary care agency which provides care to people in their own homes. Not everyone who uses this service receives 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. At the time of our inspection 10 people were receiving the regulated activity of personal care.

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

Staff had appropriate knowledge of safeguarding people from abuse. However, systems and processes were not robustly in place to show how people would be protected from financial abuse and how staff are protected against allegations. There was some conflicting information as to whether staff handled people's money, such as for shopping. People did not receive a scale of charges or a contract to show how much they paid for their care. We made a recommendation for the provider to improve transparency in communicating costs to people, and for risk assessments to be in place where people need staff support with making purchases.

People said they felt very safe being supported by care staff. Relatives were happy staff supported their loved ones safely.

Care plans were in the process of being improved using new person-centred documentation. Information was clearer than at the last inspection, regarding people’s health and how to support them safely. This was work in progress at the time of the inspection.

People felt they received safe support with their medicines and there were more regular checks/audits of medicine records. However recording of medicines needed to be improved and the medicines policy needed to be more detailed.

Recruitment procedures were more robust to ensure staff’s suitability to work with vulnerable people. Staff training had improved as had the induction process, competency checks and staff supervision. All staff spoken with felt very well supported in their role to be able to provide care safely.

Daily notes were detailed and person-centred, but closer monitoring was still needed with regard to reviewing daily notes. These were stated as being audited monthly, yet the records we reviewed showed no management oversight of these since the end of December 2021. The provider said this was addressed immediately after our visit. Some gaps in care records suggested care had not been provided at times identified; the provider explained this was in part down to poor internet connection and they were working to improve this.

Policies and procedures were still being updated and we made a recommendation the provider seeks further advice for developing these so they become meaningful documents and support how the service is run.

Roles and responsibilities were more clearly defined and consultant staff had been employed to help drive improvements in the service. Staff understood the lines of accountability and knew who to refer to with any queries or concerns. People and relatives were confident in how the service was run and they were complimentary about the quality of the care they received. Questionnaires were due to be sent to people by the end of March 2022 and the provider agreed to share the results of these with CQC.

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 16 August 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 improvements had been made and the provider had taken steps to address the breaches of regulations. There was still a breach of regulation 17 (good governance) because although the provider had made some improvements, records were still in the process of being improved to demonstrate the safe management of people’s care.

This service has been in Special Measures since 16 August 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We previously carried out an unannounced focused inspection of this service on 4 June 2021, 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; Safeguarding service users from abuse and improper treatment; Good governance; Staffing; Fit and proper persons employed; Requirements where the service provider is an individual or partnership.

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 requores 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 Caring for You 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 a continued breach at this inspection in relation to record keeping to show how well the service is run.

Please see the action we have told the provider to take at the end of this report.

Follow up

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.