Background to this inspection
Updated
8 June 2021
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
Two inspectors and two experts by experience carried out this inspection. 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 homes.
The service had a manager registered with the Care Quality Commission. 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.
Notice of inspection
We gave the service 48 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.
This was an announced, focussed inspection carried out by two inspectors. Inspection activity started on 26 April 2021 and ended 11 May 2021. The experts by experience spoke with 18 people who used the service, and 16 relatives. These calls were carried out on the 26 and 27 April 2021.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all of this information to plan our inspection.
The provider was not 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.
During the inspection
We spoke with the registered manager who is also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included eight people’s care records and eight medication records. We also looked at four staff files in relation to recruitment.
After the inspection
A variety of records relating to the management of the service, including audits, policies and procedures were reviewed. We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.
We spoke with two social care professionals, and seven care staff who worked at the service.
Updated
8 June 2021
About the service
Progress House is registered to provide personal care and support to people living in their own homes. At the time of our inspection Progress House was providing personal care to 120 people.
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.
People’s experience of using this service and what we found
Risk assessments required more individualised detail to ensure that care staff had clearer guidance on how risks were to be mitigated. Care plans also required more detail, particularly where people were living with dementia, had health conditions, or poor mental health.
The recording within medicines administration records was improved, but we found some discrepancies between what was written in the care plan, and what people were prescribed.
The majority of people told us that care staff were reliable, but sometimes they arrived later or earlier than agreed. They also reported that rotas which detailed who would be visiting them could change and they weren’t always advised of this.
The provider's governance systems had been effective at monitoring the quality of care in some areas but not all, resulting in issues not always being identified and therefore improved where required.
The majority of people we spoke with told us that the carers who visited them were kind and caring, and ensured they were treated with respect.
The provider had responded to the COVID-19 pandemic promptly, implemented policies in line with guidance and ensured all care staff had access to personal protective equipment (PPE). Systems were in place to protect people from the risk of abuse and avoidable harm.
There were sufficient care staff to cover all visits. The necessary checks had been made to ensure that care staff working at the service were of good character.
People's complaints were listened to and acted upon to improve the quality of care they received. However, some people told us that issues were still on-going in relation to changes to their rota and times of visits.
The service had an open and positive culture. Care staff felt supported and able to speak with the registered manager at any time.
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 Requires Improvement (published 19 March 2019) and there were two breaches of regulation. The service remains rated requires improvement. 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 in some areas, however we found some repeated issues which meant the provider remains in breach of one regulation relating to good governance.
Why we inspected
We carried out an announced comprehensive inspection of this service on 13 and 18 February 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and governance systems.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of safe, responsive and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has not changed and remains 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 Progress House on our website at www.cqc.org.uk.
We have found evidence that the provider needs to make improvement. Please see the safe, responsive and well-led sections of this report.
You can see what action we have asked the provider to take at the end 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 have identified breaches in relation to good governance at this inspection.
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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good.