Background to this inspection
Updated
22 June 2019
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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The planned inspection for the service was brought forward because information of concern had been shared with the Care Quality Commission (CQC). This information had predominantly included concerns about poor matches between ‘client’ and live-in carer and the poor level of communication people’s representatives experienced from the agency’s office. In some cases, there had been concerns relating to the quality of care provided. These concerns had been investigated by the agency and some had been substantiated and subsequent action taken.
This inspection examined the systems and processes in place which were designed to ensure people received a safe, effective, caring and responsive service. It also examined the agency’s management arrangements and the effectiveness of their quality monitoring systems.
Inspection team:
The inspection was predominantly completed by one inspector who was joined by a second inspector on 5 March 2019.
Service and service type: Corinium Care Ltd is a domiciliary care agency (DCA) which only provides live-in care staff to people in their own homes.
The service is required to have a registered manager. At the time of the inspection there was not a registered manager. The previous registered manager had left in September 2018. A registered manager and the provider are both legally responsible for how the service is run and for the quality and safety of the care provided. A regional manager was providing management support and planned to apply to be the registered manager until a permanent candidate could be identified.
Notice of inspection:
We gave the service three days’ notice of the inspection site visit because we wanted to ensure that managers responsible for supporting the service would be available.
Inspection site visit activity started on 20 February 2019 and ended on 11 March 2019. We visited the office location on 20, 21 and 22 February 2019 when we spoke with managers, office staff and reviewed care records, policies and procedures and other service management records. We visited the office site on 5 March 2019 to meet with care staff and visited again on the 11 March 2019 to meet representatives of the provider.
What we did:
Before inspection: We reviewed all the information we held about the service which included, information of concern and statutory notifications. Statutory notifications are when the provider notifies CQC about events which they must legally make CQC aware of. A Provider Information Return, as part of the Provider Information Collection, had not been received prior to this inspection as the inspection was brought forward. Providers are required to send us key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
During inspection: We spoke with two people and their live-in carers in their homes. We spoke with one care manager who was carrying out a review visit with one of these people. We also received feedback, by email or telephone call, from two further people who used the service and 15 representatives of people. At the agency’s office we spoke with eight live-in carers, one other care manager, members of the ‘bookings’ and ‘client contact’ teams, the training manager and the communications, marketing and recruitment manager. We spoke with the regional manager, the operations director (Nominated Individual for the provider) and the chief operations officer.
We reviewed the care records of seven people. These included the initial assessment of need, risk assessments and suppor
Updated
22 June 2019
About the service:
Corinium Care Ltd provides live-in support to people in their own homes. At the time of the inspection 176 people across England and Wales received support from the service to meet their personal care needs.
The Care Quality Commission (CQC) only regulates the regulated activity of personal care; this inspection report only relates to the provision of personal care.
People’s experience of using this service:
• The majority of people and their representatives (the agency’s clients) told us they were satisfied with the care provided to them by their live-in carers. These people often had the same live-in carers and well-established relationships with them.
• These people spoke positively about their care provided by the live-in carers. Comments included: “It’s like having another daughter, we get on so well, that’s so important. I’m hugely lucky”, “[Name of carer] is excellent” and one person’s representative described the care saying, “It’s of the highest quality and standard.”
• Prior to and during the inspection we received less positive feedback from some people and their representatives. They had experienced more changes in live-in carers than they had initially expected or wanted, had experienced an unsatisfactory client and live-in carer match and had experienced a lack of standard in the quality of the live-in carer provided.
• A common area of dissatisfaction was the level of communication people experienced from the agency’s office, particularly at times when a new or replacement live-in carer was to be organised.
• In 2018 there had been several changes in managers responsible for managing the agency’s office and the provision of care, as well as changes in care managers and office staff. Changes in office staff had impacted on the agency’s ability to always communicate with the 'client' in a way which best suited them.
• Care managers assessed people’s needs and were key in helping the office staff understand the type of carer needed. They reviewed people’s support plans, communicated with the ‘clients’ and were there to resolve any communication or care issues. One person’s representative had experienced several changes in care manager, they said, “I can never speak to the same person twice.”
• Prior to our inspection senior managers had been aware of where the service needed to improve and during the inspection they openly discussed with us, and shared with us, their action plans to address this.
• We found many improvement actions had already started but which needed now to be sustained. These included improved guidance for staff working in the office (‘bookings’ and ‘client contact’ teams), changes to the recruitment and induction process for live-in carers and better arrangements for ensuring ‘client’ support calls were made where required.
• At the time of the inspection a regional manager was managing the office and supporting the organisation of all care support. The office teams were more settled and working well together; benefiting from the improved management support.
• We found improvement actions had also started, in relation to ensuring accident and incident records, mental capacity assessments and best interests meeting records and investigation records were completed and maintained. Also, to make sure consent, when obtained, was always recorded. Further training and discussion around investigation recording and accident and incident reporting and recording was to take place with care managers.
• These areas of improvement needed to be embedded in practice and then sustained to evidence that the provider’s actions had been effective in bringing about the required improvements for people.
Rating at last inspection:
Service rating was Good; inspection report published on 15 January 2018.
Why we inspected:
The most recent inspection, started on 20 February 2019, was brought forward due to information of concern received by CQC.
Follow up:
We will continue to monitor intelligence we receive about the service and to liaise with the provider about the improvements they are making to their service. We will return to inspect the service as per our inspection programme. If any concerning information is received we may inspect sooner.
We will also ask the provider to send us an improvement plan showing the action they are going to take to improve the key question; ‘Is the service Well-led?’ to at least Good.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk