Archived: Community Care Direct

Updated 26 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

The inspection was carried out by an 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 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 19 July and ended on 26 July 2021. We visited the office location on 26 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. We used all this information to plan our inspection.

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.

During the inspection

We spoke with five people who used the service and three relatives/supporters about their experience of the care provided. We received feedback from ten members of staff as well as the nominated individual for the provider. The registered manager was not present at the inspection.

We reviewed a range of records. This included three people’s care records and 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 audits, policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We asked for more reassurances from the provider with respect to concerns around staff competency to administer medications and the updating of care records.

Updated 26 August 2021

About the service

Community Care Direct is a home care provider which offers domiciliary care and support for people within their own homes. The service was providing support to 40 people at the time of the inspection.

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

At the last inspection in September 2020 we had found the provider in breach of regulation with regards to the governance and running of the service. At this inspection we found continued management issues and there was a lack of overall governance and monitoring systems. The provider remains in breach of regulation.

There remained a lack of clarity regarding the senior manager roles in terms of the running of the agency. Since the last inspection the registered manager had maintained safe standards of care as reported by people using the service. However, there had been no development with respect to auditing systems to monitor and ensure safe standards were maintained. The overall governance of the service was poor with a lack of updated records being maintained in staff training, care, medicines and assessing clinical risk.

People reported good support regarding the management of their medicines and told us they get their medicines on time. There were some anomalies with medication records and the auditing processes had not been carried out effectively and had not picked these up. Although staff underwent training, they were not being formally monitored in terms of their ongoing competency to administer medicines. These findings were similar to the last inspection. Following our feedback, the provider ensured all staff administering medications had been checked for competency.

The agency had move location since the last inspection and were in the process of staff recruitment. There was enough staff to carry out the care and support needed. Current staff had been recruited safely.

People's experience of using the service was mostly positive. People told us they received their care and support when required and at their preferred times. People and family members told us staff were helpful and kind.

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For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Requires improvement (published 16 December 2020). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

The provider completed an action plan after the last inspection to show what they would do and by when to improve the governance and management of the service. At this inspection enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

The inspection was prompted in part due to a safeguarding concern received about the support and care for a person. We also had some concerns about the service being responsive to regulatory requirements such as timely submission of statutory notifications. The service was also in breach of regulations from the last inspection. A decision was made for us to inspect and examine those risks. We undertook a focused inspection to review the key questions of safe and well-led only.

We have found evidence that the provider needs to make improvement. Please see the Safe and Well led key question of this full report.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has remained requires improvement. 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 Care Concern (UK) 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 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 to good governance 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.

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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.