Careessence

Updated 29 December 2022

The Inspection

We carried out this performance review and assessment under Section 46 of the Health and Social Care Act 2008 (the Act). We checked whether the provider was meeting the legal requirements of the regulations associated with the Act and looked at the quality of the service to provide a rating.

Unlike our standard approach to assessing performance, we did not physically visit the office of the location. This is a new approach we have introduced to reviewing and assessing performance of some care at home providers. Instead of visiting the office location we use technology such as electronic file sharing and video or phone calls to engage with people using the service and staff.

Inspection team

The inspection was conducted by one inspector.

Service and service type

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

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered Managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a Registered Manager in post.

Notice of Inspection

In line with our new approach, we gave short period notice of this inspection and explained what was involved under the new methodology. Inspection activity took place on 21 and 27 October 2022.

What we did before the inspection

We looked at all the information we held about the provider, which included information they provided us when they were registered. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection.

During the inspection

This performance review and assessment was carried out without a visit to the location's office. We used technology such as video calls to enable us to engage with people using the service and staff, and electronic file sharing to enable us to review documentation.

We spoke with one relative. The person using the service was unable to speak with us due to communication needs. We spoke with three staff members and the registered manager. We reviewed a range of records. This included two staff files in relation to recruitment and staff supervision and care plans and risk assessments. We also looked at a variety of records relating to the management of the service, including policies and procedures.

Updated 29 December 2022

About the service

Careessence is a domiciliary care agency providing personal care to people living in their own homes or flats. The domiciliary care agency is registered to provide a service to people over and under the age of 65 years. The agency also provides 24-hour live-in care and support.

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. At the time of the inspection, one person was using the service who was receiving 24-hour care and support.

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

Risk assessments were not robust to ensure people received safe care. Care documentation was not always personalised and at times was contradictory or unclear. The provider’s quality assurance framework failed to identify shortfalls with documentation or recognise how improvements could be made. Best practice guidance had not always been followed and medicine care plans lacked information on the medicines prescribed and potential side effects. We have made a recommendation about the management of medicines.

Relatives were happy with the care provided. One relative told us, “The manager is very knowledgeable, professional and hands on.” Relatives felt the service and staff provided safe care. People received care from consistent staff members who knew and understood their care needs well. There were enough suitable staff to cover all the care calls. Staff understood their responsibilities for safeguarding adults.

People's care needs were assessed before they started to use the service. People were supported by staff who received a full induction to the service. Relatives felt staff were skilled and competent. Staff spoke highly of the support they received from the registered manager. A programme of supervisions and spot checks took place to ensure staff were well supported. People, relatives and staff were encouraged to offer feedback on the service and how it could be improved.

Procedures were in place to reduce the risk of infections and staff had regular access to personal protective equipment (PPE). Staff had received training on infection control and COVID-19 and had access to a range of infection control policies and procedures. People and relatives spoke highly of how staff had worked during the pandemic and managed the risks associated with COVID-19.

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.

Staff treated people with dignity and respect. Staff also understood the importance of promoting people’s independence. Relatives confirmed that their loved one’s privacy and dignity was always respected. Staff had received training in equality and diversity. Staff understood the importance of people’s faith and how it was important to them.

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 4 December 2019)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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 this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment and good governance

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