Background to this inspection
Updated
22 June 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 carried out by 1 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 24 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 16 May 2023 and ended on 31 May 2023. We visited the location’s office/service on 17 May 2023.
What we did before inspection
We reviewed information we had received about the service since their registration. We sought feedback from the local authority. 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 spoke with 5 people who used the service and 4 relatives about their experience of the support they received. We also spoke with 11 members of staff including the registered manager, support workers and the provider’s quality assurance manager.
We reviewed a range of records, including 7 people’s care and medicine records. We looked at 2 staff files in relation to recruitment. A variety of records relating to the management of the service, including quality assurance, complaints and safeguarding were reviewed.
Updated
22 June 2023
About the service
Ornate Healthcare Trafford is a domiciliary care agency. It provides personal care to people living in their own homes. At the time of our inspection, the service was providing support to 76 people, all of whom received support with the regulated activity ‘personal care’. This is help with tasks related to personal hygiene and eating. We also considered any wider social care provided.
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 provide 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.
People’s experience of using this service and what we found
The registered manager did not have the support to manage a domiciliary care agency providing care and support for over 70 people. There were plans to increase the management role of a team leader, but no confirmed timescale for this to take place. A quality assurance system was in place, but this hadn’t identified the shortfalls found during this inspection.
People received their medicines as prescribed. We have made a recommendation for staff medicines competencies to be regularly assessed and ‘as required’ medicines guidance to include more detail. Care and support plans identified peoples support needs and provided guidance for meeting these needs and managing identified risks. We have made a recommendation to review care plans to ensure all people’s needs are identified. People and their relatives had been involved in agreeing and reviewing the care and support plans.
Four out of 9 people or their relative said the less experienced care workers did not communicate as well as the more experienced colleagues. Staff received the training for their role and felt supported by the registered manager. However, spot checks and supervision meetings had not been completed as planned. Staff were safely recruited.
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 were supported to maintain their health and nutritional needs where applicable. People were supported to take part in local community activities where this was part of the agreed support.
People and relatives said communication with the service was good. Any incidents or complaints were investigated and resolved.
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 25 May 2022, 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 have identified a breach in relation to the governance and oversight of the service. We have made two recommendations about medicines management and capturing all people's needs in the care plans.
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.