Archived: Kingston Upon Thames

Updated 28 February 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

This inspection was carried out by two inspectors.

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 did not have 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 would be in the office to support the inspection.

Inspection activity started on 31 July 2020 and ended on 7 August 2020. We visited the office location on 31 July 2020.

What we did before the inspection

We reviewed information we had received about the service since their previous 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 one person and two relatives. We also spoke with three staff members, this included care staff and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We looked at two care files, three staff recruitment files, training records, policies and procedures and other records relating to the management of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at audits, policies and risk management plans.

Updated 28 February 2021

About the service

Kingston-Upon-Thames is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults. At the time of the inspection, there were two people receiving the regulated activity of personal care.

People’s experience of using this service and what we found

People were not always protected against avoidable harm as the nominated individual failed to ensure risk management plans were robust. People’s medicines were not managed in line with good practice. Incidents and accidents were not always recorded, and lessons were not learnt when things went wrong. People were protected against the risk of cross contamination as there were infection control measures in place. People were protected against the risk of harm and abuse and staff received safeguarding training to keep people safe. People received care and support from staff that had undergone pre-employment checks.

People did not receive a service that was well-led. The service continued to be without a registered manager. There continued to be widespread failings in the management of the service. The service continued to be delivered from an un-registered location. Audits undertaken failed to identify issues found during the inspection. The nominated individual failed to ensure there was continuous learning and improvement of the service. Records confirmed people’s views were sought and there was evidence the service worked in partnership with other healthcare professionals.

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 inadequate (published 7 April 2020).

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. As a result, we undertook a focused inspection to review the Key Questions of Safe and Well-led only.

We reviewed the information we held about the service. Ratings from previous comprehensive inspections for those Key Questions were used in calculating the overall rating at this inspection.

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

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Kingston Upon Thames on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment, good governance and registration requirements 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 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.

Special Measures

The overall rating for this service is 'Inadequate' and the service remains in 'special measures'. This means we will keep the service under review and, if we do not propose to cancel the provider's registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration. For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.