Care @ Home Newbury Ltd

Updated 13 April 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 1 inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service 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

We gave a short period notice of the inspection. This is 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 23 February 2023 and ended on 20 March 2023. We visited the location's office on 6 and 20 March 2023.

What we did before the inspection

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 liaised with safeguarding and care quality representatives from the relevant local authorities. We reviewed notifications and information we held about the service. We used all this information to plan our inspection.

During the inspection

We spoke with 3 people who used the service and 7 relatives about their experience of care and support provided. We spoke with the registered manager, operations director and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We sought feedback from 7 members of care staff. We received feedback from 2 members of care staff.

We reviewed a range of records. This included 6 people's care and support plans, 6 people's medicines administration records (MARs), staff competency checks, 4 staff recruitment files, the provider's policies for safeguarding, medicines management, consent and duty of candour. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

Updated 13 April 2023

About the service

Care @ Home Newbury LTD is a domiciliary care agency providing personal care to people in their own homes. The service provides support to older people, people living with dementia and people with a physical disability. At the time of our inspection the service was providing personal care to 24 people.

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

Medicines were not managed safely. Care plans did not contain sufficient and detailed guidance for staff to enable them to provide individualised care for people.

There was a lack of evidence of mental capacity assessments having been completed for people where information indicated people may not have the capacity to consent to receiving different aspects of care and support.

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; however, the policies and systems in the service did not always support this practice.

There was a lack of evidence to show plans were in place to support people in their last days.

Although the provider had made improvements in governance and leadership some additional work was needed to ensure continuous and sustained improvement.

People were involved in planning their care and support and were encouraged to express their views on the care and support provided. The provider maintained a log of concerns and complaints which showed actions were taken by staff when concerns were raised.

People, staff and people’s representatives were involved in how the service was run. The provider supported staff to learn through supervisions, spot checks, competency observations and staff meetings. The provider worked in partnership with external professionals to help meet people’s health and wellbeing needs.

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 inadequate (published 29 July 2022) and there were 8 breaches of regulations.

We served a warning notice against the provider and issued seven requirement notices. 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 the provider had complied with some regulations but remained in breach of other regulations.

This service has been in Special Measures since 29 July 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We carried out an announced, comprehensive inspection of this service on 29 July 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the safety of people, the effectiveness of care and ensure the service was well-led.

We undertook this comprehensive inspection to check they had followed their action plan and to confirm whether they now met legal requirements.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Care@Home Newbury LTD on our website at www.cqc.org.uk.

We have found evidence the provider needs to make further improvements.

Enforcement and Recommendations

We have identified continued breaches in relation to person centred care, consent, safe care and treatment and good governance. Please see the action we have told the provider to take at the end of this report.

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 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. We will also continue to meet with the provider to discuss their progress towards achieving compliance with the regulations.