Background to this inspection
Updated
25 November 2022
The inspection
We carried out this performance review and assessment under Section 46 of the Health and Social Care Act 2008 (the Act). We checked whether the provider was meeting the legal requirements of the regulations associated with the Act and looked at the quality of the service to provide a rating.
Unlike our standard approach to assessing performance, we did not physically visit the office of the location. This is a new approach we have introduced to reviewing and assessing performance of some care at home providers. Instead of visiting the office location we use technology such as electronic file sharing and video or phone calls to engage with people using the service and staff.
Inspection team
This inspection was carried out by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
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 the service 48 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.
Inspection activity started on 26 October 2022 and ended on 04 November 2022.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used information gathered as part of our monitoring activity that took place on 14 September 2022 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.
During the inspection
This performance review and assessment was carried out without a visit to the location’s office. We used technology and electronic file sharing to enable us to review documentation. We met with the registered manager via a videocall on 26 October 2022 and reviewed documents relating to people’s care and overall management of the service. We spoke with three people and two relatives on 01 November 2022. On 03 November 2022 we spoke with two staff and the registered manager. We reviewed further information relating to consent, safe care, training and management of the service.
Updated
25 November 2022
About the service
Julee Care Limited is a domiciliary care agency providing care and support to older people in their own home. At the time of our inspection there were 26 people using the service.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. Where they do, we also consider any wider social care provided.
People’s experience of using this service and what we found
Risks relating to people’s care and support were not always assessed and care records lacked key information about how to manage those risks.
Staff were not always deployed to meet people's needs in a timely manner and at the time agreed.
Systems to administer and record medicines given to people were not robust and not understood by the registered manager or staff.
Care staff had access to training, however this did not cover all the areas required to ensure they had the right skills and knowledge to support people who used the service.
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 policies and systems in the service did not support this practice.
Quality assurance systems in place were not being fully effective and did not highlight the concerns we found during this inspection, or made improvements following previous recommendations. Notifications of significant events were not made to CQC as required.
People told us they felt safe with the care provided. People told us staff ensured people had adequate food and drink available and would support them to access healthcare professionals.
Staff were clear on what actions they needed to take in relation to infection prevention and control (IPC), including the wearing of personal protective equipment (PPE) and regular hand washing.
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 good (published 20 November 2019).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Julee Care Limited on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to safe care and treatment, staffing, obtaining consent and good governance 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 from the provider to understand what they will do to improve the standards of quality and safety. We will follow up in a couple of months and request evidence of actions taken. 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.