Sihara Care

Updated 27 September 2022

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 Health and Social Care Act 2008.

Inspection team

The inspection team consisted of one 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

Sihara care provides personal care to people living in their own houses.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the CQC to manage the service. 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. At the time of our inspection there was not a registered manager in post.

Notice of inspection

We gave the service two working days' notice of the inspection because the service provides care to people in their own homes and we wanted to make sure that management were available on the day of the inspection site visit.

We visited the office location on 12 August 2022.

What we did before the inspection

We reviewed information we had received about the service since it was registered with the CQC. 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.

The provider was asked to complete a Provider Information Return (PIR) prior to this inspection. However, the deadline for submission of this had not passed at the time of this inspection and therefore we did not use a PIR during 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.

During the inspection

During the site visit we met and spoke with the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also briefly met the HR office coordinator, care coordinator and field care supervisor who were all in the office on the day of the site visit. We reviewed a range of records relating to the management of the service.

We spoke with 13 people who received care from the agency and 13 relatives. We also spoke with seven care workers. We looked at eight people’s care records and multiple medication records as well as records relating to the management of the service and the safety and quality of people's care. We also looked at records showing us how staff were recruited and trained, and compliments received by the service. We reviewed quality assurance records, policies and procedures. We obtained feedback from one care professional.

Updated 27 September 2022

About the service

Sihara care is a domiciliary care agency providing personal care to people living in their own homes. The services they provide include personal care, housework and medicines support. At the time of our inspection the service was providing personal care and support to a total of 54 people. 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:

Areas of potential risks to people were not always identified and appropriate risk assessments were not always in place. Some risk assessments lacked detail. This could result in people receiving unsafe care and we found a breach of regulation in respect of this.

Appropriate medicines management and administration processes were in place.

People who received care from the service told us they felt safe and supported in the presence of care workers. There were systems in place to help safeguard people from the risk of possible harm.

There was a recruitment system in place. However, we noted that it was not always clear who provided references for newly recruited staff. We have made a recommendation in respect of this.

Measures to prevent and control the spread of COVID-19 and other infections were in place.

People and relatives told us that care workers were respectful of people’s privacy and dignity. They told us care workers were kind, helpful and considerate.

Staff were up to date with their training, which ensured they had the knowledge and skills to safely and effectively meet people's needs. However, we noted that in some staff records there was a lack of detail about what was discussed during supervision sessions and have made a recommendation in relation to this.

The service had a system in place to monitor the quality of the service being provided to people. However, we found that there were some instances where the service failed to effectively check various aspects of the care provided and identify deficiencies with aspects of care. For example, the service had failed to identify issues in respect of risk assessments, care plans and staff recruitment. We found a breach of regulation in respect of this.

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's care plans we looked at included details about people's medical background, details of medical diagnoses and social history. Care support plans we looked at were specific to each person. However, the level of detail in each person's care records varied and information was not consistently recorded. We also noted that a number of care plans had not been reviewed since 2020.

Systems were in place to take learning from any suggestions or complaints, should these be made.

Staff we spoke with told us they enjoyed working at the service and they were well supported by the management team and their colleagues.

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

Rating at last inspection and update

The last rating for the service was good (16 March 2021). Since the previous inspection, the provider has been taken over by different provider and is under new management, although it is the same legal entity running the service.

Why we inspected

This was a planned comprehensive inspection to review the key questions, Safe, Effective, Caring, Responsive and Well-led and rate this service.

The inspection was prompted because the service has not had an inspection since the change in provider and management.

Enforcement and recommendations

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 and will take further action if needed.

We have identified two breaches in relation to safe care and treatment 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 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.