Capital Healthcare Management

Updated 7 February 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 Health and Social Care Act 2008.

Inspection team

This inspection was carried out by one inspector. Two Experts by Experience also supported 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

Capital Healthcare Management Services is a domiciliary care agency. It provides reablement and personal care to people living in their own homes.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. 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 28 October 2022 and completed on 22 November 2022. We visited the location's office on 28 October 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used all of this information to plan our 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 used all this information to plan our inspection.

During the inspection

We spoke with 5 people and 15 relatives to seek their views about the service. We spoke with 3 members of care staff, the care coordinator, the assistant care manager and the registered manager.

We reviewed records, including the care records of 6 people using the service and recruitment files and training records 6 staff members. We also looked at records related to the management of the service such as quality audits, accident and incident, and policies and procedures.

Updated 7 February 2023

About the service:

Capital Healthcare Management is a domiciliary care agency. It currently provides personal care to people living in their own houses and flats in the community. At the time of the inspection there were 32 people using the service.

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

Risks to people were not assessed or safely managed. Risk management plans were not always in place to guide staff on how to manage these risks safely. People's medicines were not always safely managed.

Staff were not deployed to meet people's needs in a timely manner. Appropriate recruitment checks were not carried out before staff joined the service. Accidents, incidents and complaints were not always recorded and investigated, and learning was not always disseminated to staff.

We had mixed feedback about staff use of Personal protective equipment. (PPE).

Assessments were not always carried out prior to people joining the service to ensure that people's needs could be met and were not used to develop care plans. People’s end of life care wishes were not recorded in their care records.

People and/or their relatives were not involved in planning their care and support, Care plans were not always reviewed and/or updated. People's consent to care and support was not always documented. Feedback sought from people about the service was not documented to help drive improvements. Governance and audit systems were not effective at identifying and reducing risks to people's safety. There was a lack of effective leadership and oversight of the service.

Staff had received adequate training and were supported through regular supervisions. People’s privacy, dignity and independence was promoted. 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.

People told us their consent was obtained prior to staff supporting them. Wherever possible staff supported people to maintain their independence. Staff treated people with respect and maintained their privacy and dignity. People received their support from staff who they knew and described staff as kind and caring.

Rating:

The last rating of the service was Good (published on 16 November 2018)

Why we inspected:

This inspection was prompted by a review of the information we held about this service. As a result, we undertook a comprehensive inspection.

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

Enforcement

We have identified breaches in relation to support and risk management, medicines administration, person-centred care, staffing, safe recruitment, and governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Capital Healthcare Management Services on our website at www.cqc.org.uk.

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 continue to monitor information we receive about the service, which will help inform when we next inspect.