Profad Care Agency Limited

Profad Care Agency Limited is a domiciliary care service providing care to people living in their own homes so they can live as independently as possible. The service provides support with personal care to people living with dementia, people with a learning disability, autistic people, people with mental health support needs, older people, people living with a physical disability and sensory impairment. At the time of our inspection there were 35 people using the service, 33 people received support with 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

Safe recruitment processes were not always followed. Appropriate references were not consistently sought and gaps in staff employment history were not always explored and documented. People were not consistently notified about changes to their rota, so didn’t always know who would be coming to support them. Quality assurance systems had not identified this issue therefore action had not been taken to make improvements.

Care plans and risk assessments were in place to help guide staff how to reduce risks and promote safe care. There were systems to ensure safeguarding concerns were identified and reported. Staff knew how to keep people safe from the risk of infection including COVID-19, risk assessments were in place to reduce risks. Medicines were administered in line with people's care plans. Information on medicines in care plans was regularly reviewed and up to date, to support people to remain safe and well.

Assessment processes helped to inform people's care plans and people using the service were involved in this. Advice and guidance from health and social care professionals, to help provide people with effective care, were included in people’s care plans. Staff were provided with training relevant to people's needs. People were provided with relevant nutritional support where this was part of their care.

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 received care from friendly and caring staff. Staff understood how to promote people's independence and respect their privacy and dignity. People's diverse needs and choices were respected. People were listened to and involved in their care decisions.

People received personalised care and their choices were respected. Staff knew the people they cared for and provided responsive care. People were supported with communication needs. Care was provided in a way that helped to reduce social isolation and promoted people's relationships with others. People were able to provide feedback or raise complaints which were listened to and responded to.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

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 11 July 2022) and there were breaches of regulation. 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 and the provider was no longer in breach of regulations.

This service has been in Special Measures since 11 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

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Profad Care Services Limited (Derby) on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Profad Care Agency Limited is a domiciliary care service providing care to people living in their own homes so they can live as independently as possible. The service provides support to people living with dementia, learning disabilities or autistic spectrum disorder, mental health, older people, physical disability and sensory impairment. At the time of our inspection there were 27 people using the service. CQC regulates the personal care and support. 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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

Risks were not effectively assessed and mitigated. Care plans and risk assessments had not been reviewed or updated regularly as people’s needs had changed.

Medicines were not always managed or monitored effectively. We saw gaps in medication recording which had not been followed up on to ensure people remained safe and well and were given their required medication.

Staff were not always recruited safely. There were several documents missing from the recruitment and selection process to check if staff were suitable to work at the service.

The quality of care plans was variable and although people told us they had been involved in care planning, none of the documents we reviewed confirmed this.

Relatives told us people did not always receive care from friendly and caring staff. Staff understood how to promote people’s independence and respect their privacy and dignity.

People were encouraged to give feedback on the service and the provider, however people told us they did not always feel that concerns were investigated and resolved.

There was no effective management oversight throughout the service. The provider did listen to advice from the feedback throughout the inspection and began to make changes.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The service was registered on 12 November 2019 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about peoples’ care, staffing and management oversight. A decision was made for us to inspect. Due to this being the first inspection, we examined those risks as part of a comprehensive inspection.

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, safeguarding, recruitment and oversight and governance. Please see the action we have told the provider to take at the end of this report.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

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 meet with the provider and 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. The provider is not currently delivering a service to people and they will be making improvements to enable them to manage and monitor the service more effectively.