Background to this inspection
Updated
18 August 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to adults and children of all ages.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 21 April 2021 and ended on 24 May 2021. We visited the office location on 21 April 202. We had further discussions with the registered manager in relation to the service provided to children before speaking with people, their family members and staff members.
What we did before the inspection
We reviewed information we had received about the service since their registration. We sought feedback from the local authority. The provider had not completed their Provider Information Return as the time frame for them to do this had not expired prior to our inspection. This is information providers are required to send us with key information about the service, what it does well and improvements they plan to make. We took this into account in making our judgements in this report. We used this information to plan our inspection.
During the inspection
We were unable to speak with adults or children using the service due to their health conditions or due to their young age. We spoke with four family members consisting of people supporting an adult or a child. We spoke with six members of staff including the registered manager.
We reviewed a range of records including the care plans of both adults and children. We looked at care records and multiple medicine records. We also looked at files in relation to staff recruitment.
After the inspection
We continued to seek clarification from the registered manager to validate evidence found. The registered supplied us with items requested as well as with reassurances regarding the actions taken to make the necessary improvements.
Updated
18 August 2021
About the service
Newcross Healthcare Solutions Limited (Herefordshire Service) is a domiciliary care agency. The agency was providing personal care and support to adults both over and under 65 years as well as children of all ages living either in their own home or in the care of person’s in their own home.
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 there were three adults using the service receiving some degree of personal care either during the daytime or through the night. In addition, personal care and support was provided to 18 children.
People’s experience of using this service and what we found
People’s relatives believed the care provided to be safe and appropriate to meet their family members care and support needs. Care plans at times contained conflicting information and therefore did not always provide staff with information they may need to ensure the level of care people required was received.
Medicine records were not always completed to show items as administered. Audits were not in place to identify shortfalls in the completion of these records.
Risk assessments were in place however they were not always available for potential risks indicated within the care plans.
Safe recruitment processes were in place. These covered both working with adults as well as children and younger people. The registered manager and staff were aware of their responsibility in relation to safeguarding.
Staff had access to personal protective equipment (PPE) and relatives confirmed this was used appropriately. Staff received training to enable them to care and support people. This training included specialist training to meet specific needs. Staff received support through supervision and appraisal.
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.
Relatives found staff to be caring and ensured their family member had their privacy and dignity covered.
Feedback from relatives was mixed in relation to the ability of the provider to cover shifts at times of staff shortages. Similarly, the ability to have communication with office staff was mixed.
The registered manager had a good awareness of people’s needs and undertook to make improvements. These were commenced immediately after our visit to the office.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 02/11/2017 and this is the first inspection. During this time the provider has had times when they were not providing any personal care to anyone using the service.
Why we inspected
This was a planned inspection based the provider been newly registered.
We have found evidence that the provider needs to make improvements. Please see the safe, responsive 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.
The provider acted following our inspection to mitigate these risks.
Enforcement
For enforcement decisions taken during the period that the ‘COVID-19 – Enforcement principles and decision-making framework’ applies, add the following paragraph: 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 to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to the safety of medicine management, care planning and the governance of these areas.
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.