Background to this inspection
Updated
3 August 2023
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 Health and Social Care Act 2008.
Inspection team
The inspection was carried out by 1 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.
Registered Manager.
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave a short period notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 25 April 2023 and ended on 3 May 2023. We visited the location’s office on 25 April 2023.
What we did before the inspection
We reviewed information we had received about the service since registration. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 2 people and 8 relatives on the telephone about their experience of the care provided. We spoke with 11 members of staff including care staff and the registered manager. We reviewed a range of records. This included 5 people's care records including care plans, risk assessments and medicines records. We looked at staff files in relation to recruitment. A variety of records relating to the management of the service were also reviewed including safeguarding and incident monitoring, auditing processes and staff training.
Updated
3 August 2023
About the service
JM Kamau Ltd T/A ProField is a domiciliary care agency providing personal care to people in their own homes. At the time of our 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 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, assessed or action taken to mitigate risks to people. People's care plans and risk assessments did not always reflect people's current needs. The provider had not ensured all staff administering medicines were competent to do so.
Staff had received training on how to report allegations of abuse. People and their relatives told us they felt safe. Staff were recruited safely.
People and their relatives told us staff were kind, caring and respected their privacy and dignity.
People were protected from the risks of infection. Staff told us they wore personal protective equipment (PPE) to reduce the risk of spreading infections.
Right Support:
Mental capacity assessments were not always completed for decisions relating to people's care or treatment. People’s care plans required further development to include information on people’s health conditions, preferences, likes/dislikes and information on who was important to them.
Staff had not received additional training to meet people's needs. Staff had not received training in diabetes, catheter care, pressure care and interacting with autistic people and people with a learning disability.
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.
Initial assessments took place to ensure that the service could meet people’s needs prior to admission into the service. Staff worked with other healthcare professionals to ensure people’s needs were met in a timely manner.
Right Culture:
Systems were not in place to assess, monitor and improve the service. Shortfalls found during the inspection had not been identified by the provider through quality monitoring processes.
People's feedback was gathered through care review meetings and spot check visits. People and their relatives had the opportunity to provide feedback via a questionnaire.
The registered manager was 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
This service was registered with us on 8 June 2021 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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.
Enforcement and Recommendations
We have identified breaches in relation to assessing risks, medicines, assessing people’s capacity to consent and management oversight at this inspection.
Please see the action we have told the provider to take at the end of this report.
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 continue to monitor information we receive about the service, which will help inform when we next inspect.