16 February 2023
During an inspection looking at part of the service
ICare (GB) Limited-Knowsley provides support and/or personal care to people living in their 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 there were 85 people receiving support with personal care.
People's experience of using the service and what we found
We could not always be assured that people were receiving their medicines as prescribed. Staff had not always recorded the times they had administered some people's time-sensitive medicines, such as paracetamol, to evidence that safe time intervals had been observed. Guidance was not always in place for staff in relation to the application of topical creams and allergies were not always recorded on people's medicine administration record.
Whilst governance systems had improved since our last inspection, they had not been utilised effectively to identify issues we found in relation to the administration of people's prescribed medicines.
The provider and manager took immediate action during our inspection to address concerns identified in relation to medicine administration.
Risks to people's health, safety and well-being had been assessed and detailed plans were in place for staff to follow in order to keep people safe. People told us they felt safe with the staff who supported them and family members told us they were confident their relatives were well looked after.
Accidents, incidents and safeguarding concerns were recorded and acted upon appropriately. Systems were in place to ensure that learning was taken from incidents to prevent them occurring in the future.
There were enough staff available to ensure that people received their care within the agreed times. People and family members told us staff arrived on time and completed all the tasks they were required to complete. Safe recruitment processes were in place to ensure new applicants were safe to work for the service.
Staff had received training in infection, prevention and control and the provider had systems in place to ensure infection outbreaks were managed effectively.
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; the policies and systems in the service supported this practice.
Improvements had been made since our last inspection. Positive feedback had been received from people, family members and staff about the manager and the overall service provided by ICare (GB) Limited-Knowsley.
Meetings were held with staff to provide them with important information about the service. The manager and provider had worked closely with the local authority to drive necessary improvements to people's care and support.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 8 July 2021) and there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of some regulations.
Why we inspected
We carried out an announced focused inspection of this service on 25 and 30 March 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, staffing and governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service remained requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for ICare (GB) Limited-Knowsley on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to medicines management and governance. Please see the action we have told the provider to take at the end of this report.
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.