20 June 2023
During an inspection looking at part of the service
Violet Care Agency Ltd – HSCA is a domiciliary care agency providing personal care to people in their own homes. At the time of inspection, the service was providing personal care to 187 people. This includes people being supported through the enablement service. This service provides time limited support to assist people coming out of hospital to regain as much of their independence as possible.
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
Feedback about the care provided from people and their representatives was mixed. Some people told us the care they received was not of the required standard, especially when they joined the service. Other people told us they received good care once they had settled into the service and had regular care staff.
The provider had failed to manage risk when new people joined the service, in particular when they required emergency care. Systems to monitor call times and missed visits required improvement. The provider had not always ensured people’s needs were promptly assessed and staff allocated to new people had the necessary skills to meet complex needs. We received negative feedback from some professionals about staff skills and communication from the service.
The service had grown considerably in the last year. There were new staff and systems; however, this growth had not been effectively managed. Improved oversight was needed to ensure the provider understood any gaps and areas of risk. The provider was committed to resolving the issues raised at inspection and took prompt steps to address immediate concerns. They also told us they would become more involved to improve safety and increase their oversight of the service.
Care plans were detailed and personalised, however they were not always updated with information from reviews and from the new systems.
The service had enough safely recruited staff; however, improvements were needed with staff deployment to ensure people’s needs were met safely and in-line with their preferences. Staff were positive about the support they received and morale was good. The provider had a focus on nurturing and developing leaders in social care. They promoted reflection and learning.
There had been recent improvements to safeguarding practice and knowledge. The provider had recently made effective improvements following concerns raised about the administration of medicines. Staff minimised the risk of infection.
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 26 February 2019)
Why we inspected
This inspection was prompted by a review of the information we held about this service. The inspection was prompted in part by notification of an incident following which two people using the service sustained a serious injury. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk. This inspection examined those risks.
Enforcement and Recommendations
We have identified breaches in relation to governance and management of risk at this inspection.
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.