About the service PIC 24 Healthcare Ltd is a domiciliary care agency providing personal care to three people at the time of the inspection. 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 the registered manager and nominated individual were the sole employees, who were responsible for care delivered as well as the running of the service.
People’s experience of using this service and what we found
There was a governance framework in place but it wasn’t clear when some checks had taken place. Audits on care plans had not taken place and so errors identified during the inspection had not been identified. The service had a clear vision and has open communication with people, relatives and staff. People and relatives were regularly contacted by the registered manager to discuss the quality of their care. Staff were involved in meetings and decisions about the running of the service. The service worked with other service providers to support and share best practice, and with Sheffield Local Authority.
We have made a recommendation about the provider undertaking a review of their governance and audit processes.
Recruitment checks had not been carried out on new staff.
We have made a recommendation about the provider ensuring robust recruitment processes are in place.
Systems and processes were in place to safeguard people from abuse. Staff were knowledgeable about the signs of abuse and any actions they had taken were recorded and reported to the appropriate authorities. Risks to people were assessed and people were supported safely whilst maintaining their independence. Staffing levels were sufficient to support people’s needs. People were protected from infection by trained staff who had good access to personal protective equipment (PPE). Learning was considered from any incidents or occurrences, these were documented and shared with staff. Medicines were administered safely, however there was no evidence care plans were updated to reflect the changes in medication for one person although staff were knowledgeable about these changes.
We have made a recommendation about how the provider reviews and records changes in relation to people's care.
Care plans were personalised and reflected how people wished their care to be delivered. Concerns and complaints were recorded, action taken when needed and resolved with the input of the complainant. There was no one receiving end of life care at the time of our inspection.
We have made a recommendation about how the provider asks and records people’s end of life wishes.
People’s needs and choices were assessed and care plans were personalised. The registered manager was knowledgeable about MCA legislation. Staff received regular training and support. People were supported to eat and drink, where this was required, and their choices met. Staff had regular meetings to discuss care and support needs and worked closely with social workers, pharmacies and GPs to ensure people’s health needs were supported. Consent to care was recorded. 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’s preferences were recorded and their was evidence these preferences were met. Daily records showed people’s privacy and dignity was respected and promoted.
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 18 October 2018). 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 in two areas and the provider was no longer in breach of regulations. However enough improvement had not been made in one area and the provider was still in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
This was a planned inspection based on the previous rating.
We have found evidence the provider needs to make improvements. Please see the safe and well-led sections of this full report.
Enforcement
We have identified breaches in relation to safe recruitment and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
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.