Archived: @PlymouthCare

Updated 15 November 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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by an 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 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 10 October 2022 and ended on 17 October 2022. We visited the location’s office on 10 October 2022.

What we did before the inspection

We reviewed information we had received about the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We visited the office where we met with the service manager, care supervisor, the administration officer and two senior care workers. We looked at five care plans, four people’s Medicine Administration Records (MAR) and other records relating to the management of the service. We spoke with eight people and one relative, eight members of staff and two external healthcare professionals. We also contacted the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

Updated 15 November 2022

About the service

@Plymouth Care is a domiciliary care agency which was providing personal care to 64 people at the time of the inspection. It was set up to take over from failing services or where providers had taken the decision to close services. As such it has to respond quickly to sudden increases in the number of people being supported and staff numbers, sometimes with little notice or time to plan.

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

At the time of the inspection @PlymouthCare had, within the previous six weeks, taken over two failing providers. This had meant an increase of 31 people using the service within two days. The service had also taken on responsibility for the staff teams The situation had put the service under pressure which had impacted on the care and support provided.

People did not consistently receive visits in line with plans. Staff, people and their relatives told us visits were often inconsistent. This meant people were not always receiving care that met their needs and preferences.

Systems to ensure people received their medicines as prescribed were not roust. Due to erratic visit times it was not always possible to support people to take medicines which were time specific.

When the service took on new packages of care they were reliant on information provided by the previous provider to develop care plans. This information was not always reliable or available. The registered manager told us they prioritised the development of care plans so people who they considered had the highest needs had their care plans put in place first. We found two people still did not have a care plan in place. Risk assessments were not always up to date. Some people had specific health care needs but no associated care plan in place.

Managers did not have oversight of training for staff who had recently joined the agency. Staff recruited by the service had an induction which included training in areas identified as necessary for the service.

People told us although they felt safe they did not consider the service to be caring. People spoke abut a lack of communication and information when visits were rescheduled. One person told us they needed to remind staff what to do and felt they were rushed.

We were not able to view all the records we requested both during the inspection visit and after. As the training records had not been updated to include new staff we asked for the records of two new staff to be collated and sent to us. These were never received. During the inspection we were not able to view any records relating to feedback from people using the service or any staff meeting minutes. A complaint had not been recorded in line with the organisations policy.

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.

Staff had access to ‘quick guides’ which contained basic information about how care should be provided at each visit. This was available to them to view prior to attending a visit and included information about any communication needs and people’s preferences in relation to food.

Staff told us they received regular supervision and spot checks were completed regularly to assess their competency. Most staff told us they felt well-supported.

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 6 August 2021 and this is the first inspection.

Why we inspected

We carried out this inspection in order to provide a rating for the service.

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 person centred care, the management of risk and medicine systems, records and failure to notify CQC of significant events.

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.