Adonai Healthcare Services Also known as Adonai Services Limited

Adonai Healthcare Services is a domiciliary care service providing personal care to adults aged 65 and over in the Medway area. At the time of our inspection there were 20 people receiving a 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

A person said, “Yes, I am quite happy. They help me in and out of the shower.” A relative said, “We’ve had the agency since June 2023, and I’ve had a couple of concerns that I have spoken with the manager about. I do not think that some of the carers are dementia trained, and it’s a bit of a haphazard service for Dad. The carers are lovely, but they do miss things.” Although people told us they feel safe and comfortable with staff visiting them, we found that people were not always sufficiently protected from the risk of harm because care plans did not always give enough information to support people safely.

People did not have appropriate risk assessments in place and environmental safety assessments had not been completed. Medicines were not managed safely.

Staff had not always been recruited safely to ensure they were suitable to work with people they support. There was no evidence of lessons learned despite accidents occurring.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests. The provider failed to follow the principles of the Mental Capacity Act 2005. There was no evidence of people's consent or involvement in care decisions.

Staff knew people well but could not support them effectively because initial assessments were not completed by the provider prior to commencing care packages for people to ensure they could meet people’s needs. We made a recommendation about this.

The provider had a complaints policy that included information about how to make a complaint and what people could expect to happen if they raised a concern. However, this had not been followed.

The provider did not have systems in place to monitor or audit the quality of the care provided therefore could not drive improvements. Oversight and management of the service was not effective.

Staff training was not effective. People were not supported by staff who were skilled, trained and knowledgeable. Staff had not received all training relevant to meeting people's assessed needs.

Staff followed good infection control practices including wearing personal protective equipment when supporting people.

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 7 July 2022 and this is the first inspection.

Why we inspected

The inspection was prompted due to concerns received about staff deployment, people not receiving care to meet their assessed needs, dignity and respect, infection control and responding to complaints. A decision was made for us to inspect and examine those risks.

Enforcement

We have identified breaches in relation to risk management, medicines management, safe recruitment practice, staff deployment, mental capacity, person-centred care, dignity and respect, complaints management and quality monitoring at this inspection. We have made a recommendation on how the provider consider good practice guidance in relation to initial assessment of people’s care and support needs.

Please see the action we have told the provider to take at the end of this report. 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.

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.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions of their registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.