Empathy Care24 Northampton

Empathy Care24 Northampton is a domiciliary care agency providing personal care. The service provides support to children, younger adults and older people, people with dementia, mental health, physical disability, sensory impairment, learning disabilities or autistic spectrum disorder. At the time of our inspection there were 68 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 and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

Right Support:

Risk assessments and associated care plans were not consistently in place or updated to reflect people’s current needs and mitigate risks. Medicines were not always managed safely. Staff understood the signs of abuse and how to report it to protect people. Accidents and incidents were recorded but action was not always taken where needed to prevent re-occurrence.

Staff were recruited safely in line with the regulatory requirements. Staff told us there were enough staff to support people and meet their needs. However, care calls were not always completed at the planned times and some people felt their care was rushed and told us staff arrived late.

People were protected from the risk of infection and staff used personal protective equipment (PPE) appropriately in line with the latest government guidance.

People were leading their care and making their own decisions and choices in there day to day care delivery. People were mostly happy with care staff and found them to be kind and caring.

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.

Right Care:

Staff received regular training and supervision. However, not all staff had the skills and knowledge to carry out their role effectively. Senior members of staff needed further support to ensure they were competent to complete the tasks assigned to them.

People's care plans did not always provide staff with information and guidance on how to support people safely and in a person centred way. Initial assessments took place to ensure that the service could meet people’s needs. However, people's records were not always updated following a change in support needs.

There was evidence of partnership working and seeking guidance from other health care professionals to meet people’s needs. However, there was some evidence that staff hadn’t always followed guidance. People were supported with eating and drinking where required.

Right Culture:

Systems and processes were either not in place or not effective in maintaining oversight of the safety and quality of the service and identifying concerns and areas for improvement. The provider had not implemented a robust action plan to learn and improve from the previous inspection. The provider was in the process of improving how they sought feedback from people to help with driving improvement. Staff had the opportunity to share ideas and felt listened to.

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 01 January 2023). The service remains rated requires improvement. This service has been rated requires improvement for the last 2 consecutive inspections.

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 regulations.

Why we inspected

We carried out an unannounced focused inspection of this service on 24 October 2022. 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 need for consent. We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. We also checked whether the Warning Notice we previously served in relation to Regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met.

This report only covers our findings in relation to the Key Questions safe, effective 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.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Empathy Care24 on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to the safety and managerial oversight of the service at this inspection.

Since the last inspection we recognised that the provider had failed to submit notifications of other incidents and had not met the requirement as to display of performance assessments. This was a breach of regulation. Full information about CQC’s regulatory response to this is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress and continue to monitor information we receive about the service, which will help inform when we next inspect.

Empathy Care24 Northampton is a domiciliary care agency providing personal care to people in their own homes. At the time of our inspection there were 86 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 and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

Right Care:

Risks to people were not always identified or managed safely. People's care plans and risk assessments did not always reflect people's current needs. We found missing information in people’s care records in relation to equipment, pressure care and medicine administration.

Staff did not always report incidents to the registered manager or relevant office staff. Trends and patterns were not always identified by the registered manager to improve safety across the service.

People were not always protected from the risks of infection. People and their relatives told us staff wore personal protective equipment (PPE) when being cared for however, we observed staff not to be wearing face masks when supporting a person in their home.

Staff had received training in how to report allegations of abuse. People and their relatives told us they felt safe. Staff were recruited safely.

Right Support:

Mental capacity assessments were not always completed for decisions relating to people’s care or treatment. We received mixed feedback from people and relatives if staff gained people’s consent before supporting them with their care needs. Staff demonstrated an awareness of the importance of choice and consent.

Staff had access to people’s care plans and risk assessments before providing care to people. Not all people’s care plan's and risk assessments provided information on people’s current care needs and risks. Where other professionals were involved in aspects of people’s health and care, this was not always recorded in people’s care plans.

Staff had received training in moving and handling, first aid, food hygiene and mental capacity. Staff had also received training on supporting people with a learning disability and autistic people.

People were provided with enough to eat and drink. Staff kept records on when people were provided with food and drink. Staff had received training in providing nutritional support to people.

Right Culture:

Systems in place to assess, monitor and improve the service were ineffective. The shortfalls found during the inspection had not been identified by the provider through quality monitoring processes.

We received mixed feedback from people and relatives in relation to communication with the registered manager and office staff. People’s feedback was gathered through care review meetings and spot check visits. People and their relatives also had the opportunity to provide written feedback via a questionnaire.

Staff meetings gave staff the opportunity to raise concerns and discuss improvements to people’s care.

The registered manager and nominated individual were guided to review the Right Support, Right Care, Right Culture guidance to ensure they fully understand the requirements should they support people with a learning disability or autism in the near future.

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 12 February 2022) and there were breaches of regulation.

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 regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

At our last inspection we recommended that where people have the capacity to consent, their consent and agreement is clearly recorded. Improvements had not been made or sustained.

Why we inspected

We received concerns in relation to personal care support, catheter care and short care calls. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We have found evidence that the provider needs to make improvements.

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

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Empathy Care24 Northampton on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to risk management, consent to care and management oversight at this inspection.

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.

At the time of inspection, it appeared that we had not received statutory notifications for notifiable incidents. We are currently looking into this matter.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Empathy Care24 Northampton is a domiciliary care service providing personal care to people living 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. At the time of the inspection there were 68 people receiving personal care support.

People’s experience of using this service and what we found

People were at risk of not receiving their medicines as prescribed as they were not consistently receiving their calls at the planned times. There was also an increased risk of falls while people waited for staff to arrive. Staff scheduling needed better management to prevent impact on people.

The registered manager did not fully understand some of the regulatory requirements. Systems and processes were not consistently in place to ensure effective oversight of the safety and quality of the service. Business continuity plans did not contain enough guidance to manage a crisis effectively. Feedback was not collated effectively to see an overall picture of the service and help improvement.

There had been a small number of staff deployed without completing a weekly test for COVID-19. This was due to an error in the registered managers system which will be better monitored going forward.

Risk assessment and detailed person-centred care plans were in place with people and their family’s involvement. However, people felt staff did not always read them. Accidents and incidents were recorded and reported but improvements were required to the managerial oversight in this area.

Staff did not consistently receive a supervision in line with the providers policy and procedure. However, staff felt well supported and were able to share ideas. Specialist training required improvement to ensure all peoples needs could be met. Staff had received mandatory training and an induction and had regular training updates.

There were appropriate systems in place to protect people from the risk of abuse, staff were trained and understood how and where to report concerns. Staff recruitment procedures did not include requesting a full work history from leaving school but references and Disclosure and Barring Service (DBS) checks were in place.

People’s needs and risks were assessed and recorded prior to them receiving the service. Consent records had not always been signed by the person receiving the care.

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.

We recommend that where people have the capacity to consent, their consent and agreement is clearly recorded.

People were supported with meal preparation where required and care plans reflected people’s nutritional needs.

People and their relatives felt staff were kind, caring and treated them with dignity and respect, and independence was encouraged.

End of life information was in place where required.

People’s communication needs were considered and planned into care. Information could be provided in alternative formats where required.

There was a system in place for complaints and they were managed in line with the providers complaints policy.

People and staff spoke positively about the service culture and there was evidence of good outcomes for people. Some people reported some staff to be more engaging than others.

The registered manager apologised and gave explanations to people and their families when something went wrong. There was evidence of partnership working with other professionals to drive improvement.

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 3 March 2021 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about staff timekeeping and manual handling concerns. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe effective and well-led sections of this full report.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation the safety and managerial oversight of the service at this inspection.

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.