This announced inspection took place on 30 and 31 May 2017. This was the provider’s first inspection since their registration in January 2016. Impeccable Healthcare Services Limited is a domiciliary care service providing personal care to people living in their own homes. At the time of the inspection 31 people were using the service. At this inspection we identified breaches of regulations because the arrangements for the management of people’s medicines were not robust. Whilst people received their medicines, medicine administration records (MAR) entries which did not specify the dose to be taken, or the strength of medicine to be given. Assessments on staff had not been conducted to ensure they were competent to administer medicines. The support people required with their medicines was not documented in their care plans.
We also found the provider had not taken action to ensure risk assessments included appropriate guidance for staff about how identified risks should be managed safely.
The provider did not have an effective system in place to assess and monitor the quality of the care people received. They had not maintained a manual or electronic call monitoring (ECM) system record to show that they had monitored visits to people homes to ensure they received visits at the agreed times, including when they were running late had been followed up effectively and identify any patterns to address.
You can see what action we told the provider to take in respect of these breaches at the back of the full version of the report.
Staff developed people’s care plans to meet their individual needs. However, they did not record people’s preferred time for calls in their care plan and staff maintained a flexible approach to call times.
There was a registered manager in place. 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.
People and their relatives told us they felt safe with the staff. The service had clear procedures to recognise and respond to abuse. All staff completed safeguarding training. The service had a system to manage accidents and incidents to reduce reoccurrence. The service had enough staff to support people and carried out satisfactory background checks of staff before they started working
The registered manager held regular staff meetings, where staff shared learning and good practice so they understood what was expected of them at all levels. Staff said they enjoyed working for the service and they received good support from the registered manager.
The provider involved people and their relatives, where appropriate, in the assessment, planning and review of their care. Staff supported people in a way that was caring, respectful, and protected their privacy and dignity. The provider sought the views of people who used the service.
The service provided an induction and training to staff. Staff were also supported through regular supervision and spot checks to help them undertake their role.
People’s consent was sought before care was provided. The registered manager and staff understood the Mental Capacity Act 2005 (MCA) and acted according to this legislation.
Staff supported people with food preparation where required, in order to maintain a balanced diet. People’s relatives coordinated health care appointments to meet people’s needs, and staff were available to support people to access health care appointments if needed.
The service had a clear policy and procedure for managing complaints. People knew how to complain and told us they would do so if necessary. The service had maintained a complaints log, which showed that when concerns had been raised, senior staff investigated and responded in a timely manner to the complainant.