Background to this inspection
Updated
22 April 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by an inspector, an assistant inspector and an Expert by Experience. 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
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because we wanted the provider to contact as many people as possible to enable us to call them before, during and after the inspection. Inspection activity started on 21 February 2020 and ended on 26 February 2020. We visited the office location on 24 and 25 February 2020.
What we did before the inspection
We reviewed information we had received about the service since the last inspection under the previous provider. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection-
We spoke with 16 people who used the service and 10 relatives about their experience of the care provided. We spoke with 19 members of staff including the registered manager, regional manager, care co-ordinators, care field officers and care workers.
We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
22 April 2020
About the service
Sage Care (West Midlands) is a domiciliary care service registered to provide personal care. At the time of the inspection the service was providing care to 295 people in their own 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.
People’s experience of using this service and what we found
Systems and processes in place had failed to identify a number of areas that we found during the inspection. Guidance given to staff to ensure people received their medicines as prescribed was not consistently followed for one person. Staff were not routinely provided with travel times between calls and call monitoring systems were not effective in identifying where people’s calls were consistently late or had been changed by care staff.
Systems were in place to record and act on accidents and incidents, but these were inconsistently recorded. Where these events had been recorded, there was a lack of analysis taking place of the information gathered. This meant opportunities could be lost to learn lessons from events. People’s views of the service were sought through telephone and face to face surveys, but where concerns had been raised, they were not consistently responded to and acted on.
The service had been taken over by new providers approximately 12 months ago. Staff felt well supported and described the process of transferring from one provider to another as seamless.
People were happy with the service they received and felt safe when supported by staff in their own home. Staff were aware of the risks to the people they supported and had been provided with the training and information required to support people safely.
People were happy with the support they received with their medication, but we found systems had failed to identify gaps in recording in Medication Administration Records [MARS]. Staff used correct equipment, such as gloves and aprons when assisting people.
People were supported by staff who felt supported and listened to and had their competencies regularly assessed to ensure they continued to support people in line with their care needs.
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.
Staff were aware of people’s individual needs and preferences and where support was required at mealtimes, this was provided. Staff were aware of people’s individual healthcare needs and supported them to access a variety of healthcare services where appropriate.
People considered staff to be kind and considerate and had positive relationships with the care staff who supported them. People were given choices and supported to make their own decisions where possible. Staff supported people to be independent and ensured their privacy and dignity were maintained.
People and their relatives felt involved in the development of the care plans. Care plans were reviewed and updated and staff were kept informed of any changes in people’s care needs. The service was responsive to people’s changing needs. Where people had raised complaints, they were responded to appropriately and people told us they were happy with the outcome.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
This service was registered with us on 26 February 2019 and this was the first inspection.
Why we inspected
This was the first planned inspection of the service.
Enforcement
We have identified a breach in relation to Regulation 17 in relation to the management and the oversight of the service.
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.