Background to this inspection
Updated
15 February 2024
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
This inspection was undertaken by 1 inspector and 2 Experts by Experience who made telephone calls to people. 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 homes.
Registered Manager
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 24 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 28 November 2023 and ended on 11 December 2023. We visited the location's office on 11 December 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 12 people who used the service about their experience of the care provided. We spoke with the registered manager and office staff during our inspection visit.
Following the visit, we had email or telephone correspondence with a further 14 staff members.
We reviewed a range of records. This included 6 people's care records and medication records. We looked at 6 staff files in relation to recruitment and staff supervision. We reviewed records relating to the management of the service including quality assurance monitoring and the services policies and procedures.
Updated
15 February 2024
About the service
Care Signature Christian Homecare Services Limited is a domiciliary care service providing personal care to people in their own homes. At the time of our inspection there were 27 people receiving support from this service.
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
Recruitment checks were not sufficiently robust to ensure care staff were suitable to work with vulnerable people. Appropriate safety checks were not consistently in place before care staff started work.
Improvements were needed to ensure people all had a sufficiently detailed care and risk management plan in place. We found some inconsistencies which the registered manager took action to address straight away.
We received mixed feedback from people in relation to receiving regular care staff for their visits. The registered manager was in the process of taking action to address this. Staff had received an induction when they first started working at the service, and training relevant to their roles was either planned or had already been undertaken.
The provider’s systems and processes were not always effective in helping to identify where improvements were required.
Care staff had received training in safeguarding people. Staff we spoke with were confident on how to report concerns. 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.
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 this service was good (published 24 April 2018).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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 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 Care Signature Christian Homecare Services Limited on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to the safe recruitment of care staff as well as the provider’s 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.