Background to this inspection
Updated
11 March 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 completed by 1 inspector.
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
This inspection was announced.
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 02 February 2023 and ended on 09 February 2023. We visited the location’s office on 02 February 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. 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 used all this information to plan our inspection.
During the inspection
We spoke to 2 people about their experience of the care provided. We spoke with 3 members of staff including the registered manager who is also the provider and care staff.
We reviewed a range of records. This included 2 people's care records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
11 March 2023
About the service
Flames Healthcare Ltd is a domiciliary care agency. They provide personal care to people living in their own homes.
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 2 people were receiving personal care.
People’s experience of using this service and what we found
Recruitment processes were not always followed to ensure staff working with people were of good character. Staff worked with people prior to having satisfactory references from previous employers and before having a disclosure and barring check. This meant the provider could not be assured of staff's conduct in previous employment.
Risks to people had been assessed however the strategies to mitigate these risks had not always been recorded. The tasks people required support with on each call were not always documented.
Management oversight required improvement. When information was audited the registered manager did not always analyse the information fully to ensure improvements were identified and actioned.
People were supported by staff who knew them well and had training to understand their needs. People had a consistent staff team supporting them. People knew the registered manager and were able to contact them when required.
Staff protected people from infections by wearing appropriate personal proactive equipment such as gloves, masks and aprons as required.
People were protected from potential abuse and harm. Staff received safeguarding training and understood the procedures to follow if they had any concern. People felt safe with staff.
People were supported to access healthcare as needed. Staff liaised with healthcare professionals and ensured referrals were made if appropriate.
Staff were supported by the registered manager, they received regular supervisions and team meetings. Information was shared with staff.
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.
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 21 June 2022) and there were multiple breaches of regulation.
Following our last inspection, we served a warning notice on the provider. We required them to be compliant with Regulations 17, 18 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, by 25 August 2022.
At this inspection we found the provider remained in breach of regulations.
Why we inspected
We carried out an announced comprehensive inspection of this service on 22 April 2022.
We undertook this focused inspection to check and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements. Breaches of legal requirements were found.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has not changed from requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Flames Healthcare Ltd on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified continued breaches in relation to safe recruitment of staff and management oversight 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, which will help inform when we next inspect.
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.