28 October 2022
During a routine inspection
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.