Jigsaw Homecare Ltd

Updated 20 August 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

This 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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 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 13 July 2022 and ended on 22 July 2022. We visited the location’s office on 13 July 2022.

What we did before the inspection

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 sought feedback from the local authority. We reviewed information we had received about the service since the last inspection. We contacted Healthwatch for feedback. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all this information to plan our inspection.

During the inspection

We visited the office on 13 July 2022 and spoke with the registered manager, deputy manager and care coordinator. We reviewed audits and recruitment files. On 15 July 2022 we spoke with six people who used the service and 15 family members of people who use the service. We sought feedback from 10 care staff. We reviewed the care and associated medicine records of eight people.

Updated 20 August 2022

About the service

Jigsaw Homecare is a domiciliary care agency providing personal care to older people, some of which were living with dementia. The service supported 99 people at the time of the inspection. Not everyone who used the service received personal care. The Care Quality Commission (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. There were 44 people receiving a regulated activity at the time of the inspection.

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

People’s lived experience of receiving support from Jigsaw Healthcare had improved since our last inspection. People’s individual risks had been assessed; however, staff were still not provided with guidance to support and manage them.

People’s records did not consistently contain all the information required to be able to support them in a personalised way, there was also a lack of recorded information around people’s capacity.

The registered manager had made improvements with the governance of the service by implementing audits and carrying out quality monitoring. Despite improvements made this continued to be an area of improvement and audits implemented needed to be embedded and sustained. People and staff felt more involved in the service and supported.

Medicines management had improved; however, we made a recommendation around guidance for staff on medicines administered when required. People were receiving their calls more consistently, both in terms of timings and lengths. People received care from staff who were trained to undertake their role, who felt supported and had been recruited safely.

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 did not always support 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 inadequate (4 April 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made. However, the provider remained in breach of some regulations.

This service has been in Special Measures since 4 April 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We undertook this focussed inspection to check whether the Warning Notices we previously served in relation to Regulation 12, 13, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met.

This report only covers our findings in relation to the Key Questions Safe and Well-led. 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 changed from inadequate to 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 Jigsaw Homecare Limited on our website at www.cqc.org.uk.

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 risk management and record keeping at this inspection.

We have made a recommendation in relation to medicine management.

Please see the action we have told the provider to take at the end of this report.