Archived: Equinox Personal Care Service

Updated 27 April 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 15 February 2017. The provider was given 48 hours’ notice because the location provides a domiciliary care service. The inspection was carried out by two inspectors.

Before the inspection we looked at information that we had received about the service and formal notifications that the service had sent to the CQC. We also reviewed the action plan sent in by the service following the last inspection. We looked at one person’s care records and risk assessments, seven staff files and other records that the service held, such as health and safety, audits of systems, policies and procedures. We looked at policies in place at the service. We spoke with one person that used the service and three staff. We were unable to speak with relatives of people that used the service due to people’s wishes.

Updated 27 April 2017

This inspection took place on 15 February 2017. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to make sure someone would be available to support us with the inspection. Equinox Care provides care and support for one person in their own home. The service works with people living with complex needs including mental health, drug and alcohol dependency and people living with physical and sensory disabilities.

At our last inspection on 16 June 2016, we found significant shortfalls in the care provided to people. We identified breaches of regulations 9, 12, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These breaches related to a lack of person centred care, a lack of risk assessments to ensure safe care and treatment, good medicines management, inadequate provision of staff appraisals and a lack of auditing processes to ensure good governance and overall management of the service provided. We were not satisfied that care and treatment was being provided safely.

Following our last inspection, we were significantly concerned around the breaches of regulations 9 and 17. This related to ensuring that care provided was person centred and overall good governance of the service. We took enforcement action and issued two warning notices. A warning notice is a type of enforcement action that sets out what was found at the inspection and requires the provider to make adequate and swift changes in order to meet the regulations. At this inspection we found that the provider had met the requirements of the enforcement action.

The provider was also placed into special measures. Special measures are designed to ensure a timely and coordinated response where we judge the standard of care to be inadequate. Its purpose is to ensure that inadequate care significantly improves and provides a clear timeframe within which the provider must improve the quality of care they provide. When a provider is placed into special measures, the CQC will re-inspect within six months.

This inspection was carried out within the six-month time frame to check if improvements to the quality of care had been implemented.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager was present during the inspection.

At our last inspection, we found that the provider was not adequately assessing and mitigating known risks for people. At this inspection, we found that although the majority of risks to people had been assessed appropriately, we found that the provider had not adequately addressed some known risks. Some of these risks were significant.

Not all staff had received an appraisal despite this being identified at our last inspection. However, staff had regular supervision that helped identify training needs and improve the quality of care.

Staff were aware of the difference between promoting and administering medicines. Medicines were managed safely.

Since the last inspection, the provider had brought in a training company to undertake staff training. Numerous training sessions had been provided and there was a plan in place for when staff required refresher training. Staff training was updated regularly and monitored by the registered manager.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

People told us that they felt safe and well supported by staff. We saw positive and friendly interactions between staff and people.

Care plans were person centred and reflected individual’s preferences. People told us that they were involved in planning their care and that the service acted on their wishes.

There was a complaints procedure and people were aware of how to make a complaint.

Services that have been given a rating following an inspection are legally obliged to display their rating on their website, if they have one, and at the registered location where care is provided. The service was displaying its rating provided by the Care Quality Commission at the last inspection on its website and in the office.

At this inspection, we found breaches of regulations 12 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.