Background to this inspection
Updated
23 August 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 Care Act 2014.
Inspection team
The inspection was carried out by one inspector, 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.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with CQC 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 a registered manager in post.
Notice of inspection
We gave a short period of notice of the inspection. This was because we needed to be sure the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 12 July 2022 and ended on 15 July 2022. We visited the office location on 12 July 2022.
What we did before the inspection
We reviewed information we received about the service. We sought feedback from the local authority and professionals who work with the service. The provider was asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all the information to plan our inspection.
During the inspection
We spoke with five people over the telephone and seven relatives about their experiences of the care provided. We spoke with the registered manager, four members of staff and received feedback from three external professionals.
We also spoke with the nominated individual; the nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included four people’s care records, multiple medication records, three staff personnel files in relation to recruitment and a variety of records relating to the management of the service, including policies and procedures.
Updated
23 August 2022
About the service
Caring Connection Ellesmere Port is a domiciliary care service that provides support and personal care to people living with dementia, physical disabilities, learning disabilities or autistic spectrum disorders and older people in their own homes. Not everyone who used the service received personal care. At the time of our inspection 19 people received support with their personal care. The Care Quality Commission (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
We have made a recommendation about staffing and recruitment. We received mixed feedback about staffing levels from staff, people and relatives we spoke with as part of the inspection. Staff also expressed that their rotas needed to be much more prepared and organised. Pre-employment recruitment checks were conducted and disclosure and barring service (DBS) checks were carried out. Elements of ‘safer recruitment’ processes needed to be strengthened.
We have made a recommendation about governance. Although quality assurance and governance measures were in place, these needed to be more effectively embedded. Additional oversight and monitoring of the service needed improving.
Risks to people were assessed and reviewed. However, we noted staff needed some additional information in relation to people’s medical/health conditions. For instance, information and guidance to follow should a person present with symptoms or signs that medical attention was required.
Medicine administration procedures were in place. Staff were trained, had their competency levels checked and there was an up to date medicines policy in place. However, additional quality assurance checks were needed in relation to the electronic medication administration record (MAR) system and care notes. The electronic systems did not always reflect the information recorded on the MARs we reviewed.
Infection prevention and control (IPC) measures and arrangements were in place. There was a COVID-19 policy staff could consult and PPE was in plentiful supply. However, we were not always assured that staff were engaged in twice weekly COVID-19 testing in line with government guidance.
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.
Safeguarding procedures were in place. There was an up to date safeguarding policy, staff received the necessary training and they told us how they would escalate any concerns they had.
Staff were familiar with the people they provided care and support to. Care records contained a good level of information that was centred around people’s wishes and preferences.
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
This service was registered with The Care Quality Commission on 18 May 2021, this was the first inspection of this newly registered service.
Why we inspected
This inspection was prompted by a review of the information we held about this service. We found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
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. Two recommendations have been made; this is a proportionate response to the corroborated evidence we found. We will continue to monitor the service and will take further action if needed.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.