About the serviceNew Age Care is a is a community-based care provider that provides personal care to people living in their own homes. At the time of inspection, the provider told us they supported 44 people who were in receipt of the regulated activity of personal care. People received care calls ranging from 30-minute calls, up to care calls requiring 24/7 live in support.
Everyone who received support at the time of our inspection, 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
We checked examples of updated care plans and found these were not always accurate or they held conflicting information. Some risk assessments although completed, needed additional information to ensure the overall risks were fully documented. Risk assessment scores failed to correctly identify whether someone was at low or high risk. This meant staff did not have accurate information in order to manage people's risks safely.
We could not be confident people received their prescribed medicines safely. Systems to support safe medicines practices were ineffective. Medicine Administration Records (MAR) did not always correlate with people’s care plans. It was not always clear what medicines a person had been prescribed or if staff administered them. In some examples, people who needed ‘as required’ medicines did not have a detailed protocol in place to tell staff, when, how and what dose of these medicines should be given safely.
People were not protected from ineffective staff recruitment checks. In one example, the provider told us about one staff member who had worked under a different identity. We checked this staff member’s recruitment file and found no checks at all were completed. In other staff files, gaps in employment histories were not explored and references were not always requested or completed by the referee. Instead, some references were completed by staff employed by the provider.
Overall, the provider failed to operate and manage a robust and effective quality assurance system. Checks we would expect to be made such as late/missed calls, daily log completion, medicines management, care plans and risk assessments were non-existent. We were not given any records to show checks were completed because the provider told us they had not completed any checks. The provider remained in breach of the regulations.
In spite of the ineffective management of the service, people and relatives told us they were pleased with the support those staff provided to them. People and families said they got on well with staff and they were complimentary about how they were supported. People and relatives confirmed they received their care and support from a regular staff team who knew them well, but in some cases, staff were changed at the last minute with no prior notice.
People’s feedback about the care showed they valued the support they received. However, people’s feedback about the management and the organisation of the service said it needed improving. Not everyone we spoke with felt comfortable sharing their experiences about the service.
Whilst people told us they received their care at the right times, we could not be confident there were sufficient staff employed safely to undertake care calls to people.
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.
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 14 October 2022) and there were breaches of regulation. Following the last inspection, we formally requested that the provider sent us a monthly action plan telling us what they had improved. At this inspection, we found the provider remained in breach of regulations.
Why we inspected
We undertook a targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about the poor management and culture at the service. We also received concerns about the lack of effective care planning, staff recruitment practices, management of people’s risks and limited oversight from the provider to ensure the service remained safe. A decision was made for us to inspect and examine those risks.
We inspected and found there was a concern with management of risks, management of medicines, staff recruitment and a lack of effective oversight and scrutiny by the provider so we widened the scope of the inspection to become a focused inspection which included the key questions of Safe and Well Led.
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 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 New Age Care on our website at www.cqc.org.uk.
Enforcement
Immediately following our visit, we sent the provider a letter asking them to respond to the immediate concerns we found at our visit. We continued to seek their updates and assurances they had mitigated the immediate risks to people.
We have identified continued breaches in relation to Regulation 12 (Safe care and treatment) and Regulation 17 (Good governance). We found an additional breach of Regulation 19 (Fit and proper persons employed).
Since the last inspection we recognised that the provider had failed to display their rating on their website. Full information about CQC’s regulatory response to this is added to reports after any representations and appeals have been concluded.
We have found evidence that the provider needs to make improvements. 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.
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.