Archived: Cera Worcestershire

Homecare4U Worcestershire is a domiciliary care agency. People had individual packages of care in their own homes. At the time of this inspection Homecare4U supported 53 people with personal care. 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 and relatives told us care staff often turned up late or early and that at times they were not informed that calls were going to be late. Care staff told us that there was not enough time between calls to ensure that they could arrive in time.

People did not always receive safe care. Risks assessments were not updated to reflect current risks to people’s safety. Where risks were identified by care staff this was not communicated to everyone that needed this information to keep people safe.

There was no system to monitor call times and the manager did not know when care staff arrived and left. Staff did not consistently log into calls at the time calls were being made. This meant the manager could not establish if people received their agreed care.

Care staff had knowledge of safeguarding and whistle blowing; however, care staff did not always feel supported to raise concerns. Safeguarding procedures had not always been effectively followed. There were examples where actions that should have been taken to keep people safe but were not always taken in a timely manner.

Safe recruitment procedures were not always followed. The registered manager had identified one member of care staff as needing additional supervision and checks to provide assurances as to their suitability for the job. This was not completed, and no assurance could be provided to what actions had been implemented to ensure this care staff member’s suitability.

There was no effective governance or oversight of the service or how it was performing.

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.

Rating at last inspection: At the previous inspection in December 2019 the service was rated Good in all areas. At this inspection we have rated this service as requires improvement in Safe, Effective and Well Led. This leads to an overall rating of requires improvement.

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

Why we inspected

We received concerns in relation to the management of risks and safeguarding. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe, effective 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.

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 our 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 identified breaches in relation to the management of risks associated with people’s care, recruitment procedures, notifications and governance of the service at this inspection.

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.

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

People were supported to remain safe in their home with guidance from care staff who understood how to protect and report suspected abuse. People’s risks were known and recorded to enable staff to provide safe care. Staff arrived on time and supported people safely with their medicines. Staff used gloves to prevent the risk of infection. Where incidents or accidents had happened these had been recorded, reviewed and any learning shared within the staff team.

People’s needs were assessed. Staff training supported and reflected the care needs of people using the service. People were helped to prepare meals or staff left snacks and drinks which were accessible to people. If needed, people were supported to access other services, such as GP’s and social services. 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.

People received care from familiar staff who were kind and considerate. People were involved in their care which staff provided while retaining people’s privacy and dignity. Staff promoted people to remain independent and do as much as they were able on their own.

People’s care was regularly reviewed and took account of their personal choice and comments. Communication needs had been assessed and staff knew how best to communicate with people. People knew how to raise a concern or complaint and these had been acted on.

People were involved in their care and had opportunities to give feedback on the service they received. The registered manager and provider reviewed records and completed checks to ensure people received safe care which met 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

The last rating for this service was good (published 22 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

At the time of our inspection 44 people received personal care in their own homes.

There was a registered manager in place at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff we spoke with knew how to protect people from harm. We found staff recognised the signs of abuse and knew how to report this. Staff made sure risk assessments were in place and took actions to minimise risks without taking away people’s right to make decisions.

People told us there were enough staff to help them when needed. Staff told us there were enough staff to provide safe care and support to people. Advanced planning meant that staffing levels were reviewed and reflected the needs of people who used the service. People’s medicines were checked and managed in a safe way.

People received care and support which met their needs and preferences and in line with their consent and agreement. Staff understood and recognised the importance of this. We found people were supported to eat a healthy balanced diet and were supported with enough drinks to keep them healthy. We found staff supported people with access to healthcare professionals, such as their doctor or hospital appointments.

People told us they were involved in planning their care. People’s views and decisions they had made about their care were listened and acted upon. People told us that staff treated them kindly, with dignity and their privacy was respected.

We found people knew how to make a complaint and felt comfortable to do this should they feel they needed to. Where the provider had received complaints, these had been responded to. Learning had been taken from complaints received and actions were put into place to address these.

Staff felt supported by the registered manager to carry out their roles and responsibilities effectively, through training and staff meetings. We found checks the registered manager completed on the service provided focused upon the experiences of people. Where areas for improvement were identified, systems were in place to ensure lessons were learnt and used to improve staff practice.