Cura-Care Yorkshire Ltd

Cura-Care Yorkshire is a domiciliary care agency providing personal care to adults and children living in their own homes. 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. At the time of the inspection, the service was supporting 37 people.

People's experience of using this service:

People were safe using this service. Staff were trained to safeguard people from abuse and knew how to minimise identified risks to people's safety. They followed current practice when providing personal care and in regard to infection control. There were enough staff available to meet people's needs. The provider carried out recruitment checks to make sure staff were suitable and fit to support people. Staff received relevant training to help them meet people's needs. The registered manager supported them to review and improve their working practices so that people experienced high quality care and support.

People received care and support that had been planned and agreed with them. People's care preferences were respected and staff delivered care in line with people’s wishes. Staff knew people well and understood how their needs should be met. The provider checked with people at regular intervals the care and support provided was meeting their needs.

People's written feedback and relatives told us staff were kind and caring. They supported people in a dignified, respectful way which maintained their privacy and independence. The provider made sure wherever possible, this was from the same staff to maintain a consistent approach. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff understood people's healthcare needs and how they should be supported in a timely and appropriate way. Staff worked well with other healthcare professionals involved in people's care.

People and their relatives had no concerns about the care and support provided. They knew how to make a complaint if they needed to. The registered manager monitored and reviewed the quality of service that people experienced. They undertook regular checks on care staff to make sure they were carrying out their duties appropriately and to a high standard. The provider sought people's views about how the service could improve.

There were arrangements in place to make sure any accidents, incidents and complaints would be fully investigated and people would be involved and informed of the outcome.

The manager was clear about the responsibilities of their role. They were open and honest and had regular communication with people, their families and other stakeholders.

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

Rating at last inspection

This service has been in Special Measures since 12 April 2021. At our last inspection we identified risks were not effectively identified or assessed and medicines were not safely managed. We also found governance arrangements within the service were not adequate to ensure safe, good quality care was being delivered.These were a breaches of regulation 12 (Safe Care and Treatment) and regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider had also failed to make legally required notifications to CQC. This was a breach of regulation 18 (Notification of other incidents) of the Health and Social Care Act 2008 (Registration) Regulations 2009

During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected:

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

Follow up:

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Cure-Care Yorkshire is a domiciliary care agency providing personal care to adults and children living in their own homes. 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. At the time of the inspection, the service was supporting around 65 people.

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

We were not assured people were being cared for safely. The provider had shown little regard to the risks presented by COVID-19. Risk assessments had not been undertaken, there was no staff testing programme in place, staff training in relation to infection control was lacking and the provider had not incorporated government guidance into their working practices. Following the inspection the provider told CQC they had implemented work to address these areas.

We found improvements were required in the way medicines were managed, and in staff use of personal protective equipment (PPE)

Governance arrangements within the service were not sufficiently robust to ensure people received safe care. Audits had failed to identify areas that needed to be improved, putting people at risk of harm.

Staff told us they understood their responsibilities in relation to safeguarding, and people using the service and their relatives told us they felt safe when receiving care. The provider had a comprehensive monitoring system for any safeguarding incidents, however, they had failed to notify CQC of a number of incidents which they were legally required to notify us about.

The majority of staff and people using the service told us they found the management team to be accessible and supportive.

Recruitment was undertaken safely, with appropriate background checks before staff started work.

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 August 2018)

Why we inspected

The inspection was prompted due to concerns received about how the provider was ensuring care was delivered safely in a way that met people’s needs, and about the provider’s governance arrangements. A decision was made for us to inspect and examine those risks. As this was a focussed inspection, we reviewed the key questions of safe and well led only. Ratings from previous comprehensive inspections for other key questions were used in calculating the overall rating at this inspection. The overall rating for the service is now inadequate.

The overall rating for this service is ‘Inadequate’ and the service is therefore 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.

Enforcement

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safety and infection control, and governance 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.

The service had a registered manager. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run. The registered manager and nominated individual were present and assisted us throughout the day.

Staff were trained to recognise signs that might show someone was at risk of abuse or harm. They knew the importance of reporting their concerns to promote people's safety.

Staff had guidance about how to minimise risks to people's safety and welfare. Staff supported people to understand risks themselves and to learn what they could do to promote their own safety and welfare. Where staff supported people with their medicines, they did so in a safe way.

There were enough staff to keep people safe. Robust recruitment and selection procedures were in place to make sure suitable staff worked with people who used the service. Staff were skilled and experienced to meet people's needs because they received appropriate training, supervision and appraisal.

Staff understood the importance of seeking consent and encouraging people to make their own decisions. If someone's capacity to make an informed decision was in doubt, staff consulted others who knew the person well. They involved the person, professionals and families to help determine what was in the person's best interests.

People's privacy and dignity was promoted and staff treated people with warmth and respect. People were encouraged to say how they wanted staff to deliver their care and, in some cases, to draw up their own guidance for their support staff.

The registered manager and staff reviewed people's care to see whether anything had changed. Staff knew about people's individual needs and preferences. They knew how to meet these and had guidance within care plans focused on each person.

People were confident that they could raise any concerns or complaints they had with the management team and have them addressed. They were also encouraged to express their views on a regular basis. This happened formally through surveys at the end of support sessions. Others connected with the service, such as family members, were encouraged to say what they thought about the service. The management team reviewed where the service was performing well and what improvements they could make in response to the views they obtained.

Staff were fully involved and committed to achieving the service's values and vision. The service had systems to monitor and review the quality of the care provided. People told us they had continuity of support staff. They said staff always arrived on time and stayed for their allocated time. People were supported by staff who demonstrated kindness, compassion and courtesy.