Background to this inspection
Updated
21 June 2022
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 two inspectors, 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 service is required to have a registered manager. A registered manager is a person who has registered with CQC to manage the service. 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.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We provided a short amount of notice of the inspection. This was because we needed to be sure the provider or manager would be in the office to support the inspection.
Inspection activity started on 10 May 2022 and ended on 12 May 2022. We visited the office location on 10 May 2022.
What we did before the inspection
We reviewed information we received about the service. We sought feedback from the local authority and professionals who work with the service. The provider was asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all the information to plan our inspection.
During the inspection
We spoke with six people over the telephone and six relatives about their experiences of the care provided. We spoke with the area manager, registered manager, recruitment manager and six members of staff.
We reviewed a range of records. This included seven people’s care records, multiple medication records, two staff personnel files in relation to recruitment and a variety of records relating to the management of the service, including policies and procedures.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
21 June 2022
About the service
Alcedo Care Wigan and St Helen’s is a domiciliary care service that provides support and personal care to children and adults in their own homes. Not everyone who used the service received personal care. At the time of our inspection 127 people received support with their personal care. The Care Quality Commission 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
People’s areas of risk was not always safely assessed or managed. Care records did not always contain the relevant information, guidance or support for staff to follow. Medical / health conditions were often recorded, however there was little or no information about the surrounding risks, management of risk or support the person may need.
Quality assurance and governance measures were in the process of being improved by the manager. We were not always assured that the current quality performance or risk management measures were always used effectively to safely monitor, manage or improve the quality and safety of care people received.
Safe recruitment measures were in place and staffing levels had improved following an extensive recruitment drive. However, we received feedback and reviewed data which indicated people had not always received support at the agreed times. The systems used to monitor the reliability of call times were not effective.
Medication administration procedures were in place. However, we were informed that the electronic system was in the process of being updated. Staff were trained, regularly had their competency levels checked and audits were being completed as a measure of monitoring compliance. We identified one concern regarding medication administration that we brought to the attention of the manager.
Infection prevention and control (IPC) measures and arrangements were in place. PPE was readily available, and staff were provided with the relevant personal protective equipment (PPE). Staff were engaged in twice routine weekly COVID-19 testing regimes.
Staff were familiar with safeguarding policies and procedures and knew how to escalate their concerns as a measure of keeping people safe. People told us they felt safe when receiving care. One person told us, “Very happy, the carers are brilliant. I feel very safe.”
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.
The majority of care records contained personalised information and staff were familiar with the people they were providing support to. However, the level of information was not always consistent across all care records we reviewed.
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
This service was registered with The Care Quality Commission on 13 April 2021 and this was the first inspection at this newly registered location. The last rating for the service (at the previous registered location) was ‘requires improvement’ (published 23 October 2019).
Why we inspected
This inspection was prompted by a review of the information we held about this service. We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report
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 and good governance
Please see the action we have told the provider to take at the end of this report.
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.