Caring Forever Limited

Updated 7 October 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 (one of whom was a member of the medicines team) and one Expert by Experience completed 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 management team would be in the office to support the inspection.

This was an announced, comprehensive inspection. Inspection activity started on 26 August 2021 and ended 13 September 2021. We visited the office location on 26 August 2021. The Expert by Experience spoke with 12 people who used the service, and seven relatives on the telephone. These calls were carried out on the 26 August 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.

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection

We spoke with the registered manager, two managing directors, and one care co-ordinator. We reviewed a range of records. This included five people's care records and five medication administration records and associated documents.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data, service policies, and quality assurance records.

We received feedback from four social care professionals who knew the service well.

We spoke with two care staff and one team leader. We also spoke with one relative following the inspection.

Updated 7 October 2021

About the service

Caring Forever Limited is a domiciliary care agency. It provides personal care to people living in their own homes. 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. At the time of our inspection the service was providing personal care to 41 people.

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

Risk assessments required more individualised detail to ensure care staff were provided with information about how risks were to be mitigated. Some known risks did not have a corresponding care plan so care staff knew how to mitigate risk as far as possible.

Medicines documentation required more detail to ensure people received their medicines consistently and appropriately.

The auditing and quality assurance systems in place required improvement, as they did not ensure accurate upkeep of full records and identify areas for improvement.

There were sufficient care staff to cover visits to people. Some people told us if care staff were running late that they weren’t always advised of this.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way. However, records required improvement to ensure best interest procedures were followed where necessary and in line with the Mental Capacity Act 2005.

Care plans required more detail, to provide guidance for care staff on how to meet people’s individual needs, particularly where people were living with dementia, had health conditions, or were receiving end of life care.

People consistently spoke highly of staff and told us they were kind and caring. People and their relatives said they were treated with respect and kindness by staff who were patient and respected their dignity. Staff were recruited safely. Staff received relevant training to carry out their role.

People knew how to contact the office and raise any concerns if needed. Complaints were investigated and responded to appropriately.

The service had an open and positive culture. Care staff felt supported and able to speak with the management team 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

The last rating for this service was Good (published 14 May 2018).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.

We have found evidence that the provider needs to make improvements. Please see the safe, responsive and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Caring Forever Limited on our website at www.cqc.org.uk.

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 a breach 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 continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We will request an action plan for 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.