Kare Support Services Ltd

Kare Support Services Ltd is a domiciliary care agency that provides personal care to people in their own homes. It provides a service to older people who have dementia, learning disabilities or autistic spectrum disorder, mental health needs or physical disability.

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 our inspection there were two people using the service.

People’s experience of using this service and what we found

The registered manager did not operate effective quality assurance systems to oversee the service. They had not identified the concerns we found through their own monitoring systems.

The registered manager did not ensure effective and safe recruitment processes were in place to ensure, as far as possible, that people were protected from staff being employed who were not suitable. The management of medicines was not always safe. Not all staff were up to date with, or had received, their competency checks and mandatory training. We did not have enough evidence to show the registered manager kept their knowledge and competencies checked and up to date.

The registered manager was able to describe how incidents or accidents were responded to. However, we were not assured they effectively identified, reported and investigated safeguarding concerns. People’s records for risk management needed reviewing to ensure more detail about how to minimise and mitigate risks were available to staff. The registered manager did not inform us about notifiable incidents in a timely manner. The registered manager did not ensure that clear and consistent records were kept in relation to people’s care and the service management. People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.

We have made a recommendation about seeking guidance from a reputable source to ensure the Mental Capacity Act (MCA) legal framework and provider’s responsibilities to people and their decisions were followed accordingly.

Staffing levels were reviewed and supported people to stay safe and well. People and staff told us there were enough staff to support people. The registered manager scheduled the visits and oversaw timings and length of visits. People and relatives were informed about the changes to their visits or the staff being late.

People, their families and other people that mattered were involved in the planning of their care. However, the care plans did not contain information specific to people’s needs and how to manage any conditions they had. This meant staff did not always have detailed guidance for them to follow when supporting people with their needs. This could put at risk of receiving inappropriate and unsafe care and support.

One person and a relative said they felt safe when staff were supporting them. They could approach the registered manager and staff with concerns. The registered manager had a process to deal with complaints, but they said they had not had any yet. Staff felt they could approach the registered manager and they communicated well in regard to the service and any related matters.

The management team was working with the local authority to investigate ongoing safeguarding cases. There was an emergency plan in place to respond to unexpected events. Staff had ongoing support via regular supervision and appraisals. They felt supported by the registered manager and other staff.

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 26 March 2021 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement and Recommendations

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 quality assurance; safeguarding management; record keeping; management of medicine; staff training and competence and recruitment. We have made a recommendation about meeting the Mental Capacity Act legal framework.

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.