About the service This service is a domiciliary care agency that provides support to people in their own homes. It provides a service to younger and older adults, people with physical disabilities, sensory impairments, mental health conditions or dementia. The provider has one domiciliary care agency within their registration. The service's office is based in Oldham, and support is provided to people in surrounding areas. At the time of the inspection it was providing a service to one person who was receiving personal care.
People’s experience of using this service and what we found
Recruitment checks were not robust to ensure staff were suitable to work with vulnerable adults before being appointed. The registered person had not ensured that all the information specified in Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 was available for each person employed.
We found the service was not following the provider’s medicine policies and PRN (as and when required medicine) protocols were not in place for prescribed PRN creams as needed. Adequate documentation was not being used to ensure medicines were administered safely and recorded accurately.
We reviewed a range of records and found improvement was required with record keeping as various records did not contain accurate dates.
People’s risk assessments were limited and did not look at areas such as moving and handling and nutrition and hydration. We have made a recommendation about assessing and reviewing risks.
The service did not routinely provide end of life care; however, people did not have the option to disclose and record their end of life wishes as part of their care planning. We have made a recommendation about giving people the option to make their end of life wishes known.
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.
People told us staff were kind, courteous and sensitive. One person said, “I trust the carers, I let them into my home. Nothing is too much”.
Staff we spoke with felt valued and supported by the management team. They were clear about the culture of the organisation and what was expected from them.
The service did not meet the characteristics of Good in all areas.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 2 July 2018 and this is the first inspection.
Why we inspected
This was a planned inspection of the service since it was newly registered in July 2018.
Enforcement
We have identified three breaches in relation to regulation 12 (Safe care and treatment), regulation 17 (Good governance) and regulation 19 (Fit and proper persons employed) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Adequate documentation was not being used to ensure medicines were administered safely and recorded accurately. Improvement was required with record keeping as various records did not contain accurate dates. Recruitment checks were not robust to ensure staff were suitable to work with vulnerable adults before being appointed.
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 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.