Background to this inspection
Updated
10 August 2021
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
One inspector visited the 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 24 hours’ 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.
Further inspection activity was completed via telephone and by email, which included speaking with people, staff and relatives and reviewing additional evidence and information sent to us by the management team. Inspection activity started on 22 June 2021 and ended on 2 July 2021.
What we did before inspection
We reviewed information we had received about the service since the last inspection. 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 two people who used the service and three relatives about their experience of the care provided. We spoke with five members of staff including the provider, registered manager and care workers.
We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at three 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.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two professionals who regularly visit the service.
Updated
10 August 2021
About the service
Shores Home Care Limited is a domiciliary care service registered to provide personal care to people living in their own homes. The service supports adults, older people and people who may be living with dementia. There were 21 people being supported by the service at the time of our inspection.
Not everyone who used the service received personal care. The Care Quality Commission (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
The provider had day to day oversight of the service but lacked robust governance systems which would provide them with assurances that people's care needs were being delivered safely and effectively.
Care plans and risk assessments were not regularly updated to reflect people’s current needs. Care plans and risk assessments for specific health conditions were not in place and records of people’s end of life wishes were not completed. Accidents and incidents were not monitored to identify themes or trends. We have made a recommendation about this.
Medicines management was monitored by the registered manager. Documentation to support the use of topical medicines was not in place. We have made a recommendation about this.
Staff understood their role in safeguarding people. People felt the service was safe and spoke positively about the staff and management team. Recruitment was safe and staff felt supported within their role.
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 were supported by a consistent group of staff. Relatives were highly complementary of the service and the care and support their loved ones received. Relatives told us the provider was approachable and were confident if they raised any concerns, they would be dealt with appropriately.
The provider and registered manager were open and honest throughout the inspection and accepting of the feedback given following the inspection.
For more details, please see the full report which is on the Care Quality Commission website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 13 January 2020) and there was a breach of regulation 17. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulation 17.
Why we inspected
We carried out an announced comprehensive inspection of this service on 16 and 17 December 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the governance of the service.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe, responsive and well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained the same. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Shores Homecare Limited 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.
We have identified a continued breach in relation to 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 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.