Background to this inspection
Updated
17 May 2023
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 carried out by an inspector, medicines inspector and 2 Experts 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
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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. However, the new manager was in the process of registering with CQC.
Notice of inspection
We gave the service a short notice of the inspection. This was because we needed to be sure that the provider or manager would be in the office to support the inspection.
The inspection activity started on 14 February 2023 and ended on 21 February 2023. We visited the location’s office on 16 and 17 February 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 and professionals who work with the service. 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 help plan our inspection.
During the inspection
We spoke with 6 people who used the service and 9 family members about their experiences of the care provided. We spoke with 5 staff, the manager and Chief Operating Officer.
We reviewed 7 people's care records and medicine administration records for 5 people. We reviewed 4 staff files in relation to recruitment and range of other records related to the overall management of the service.
Updated
17 May 2023
About the service
ICare (GB) Limited-Knowsley provides support and/or personal care to people living in their 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 our inspection there were 85 people receiving support with personal care.
People's experience of using the service and what we found
We could not always be assured that people were receiving their medicines as prescribed. Staff had not always recorded the times they had administered some people's time-sensitive medicines, such as paracetamol, to evidence that safe time intervals had been observed. Guidance was not always in place for staff in relation to the application of topical creams and allergies were not always recorded on people's medicine administration record.
Whilst governance systems had improved since our last inspection, they had not been utilised effectively to identify issues we found in relation to the administration of people's prescribed medicines.
The provider and manager took immediate action during our inspection to address concerns identified in relation to medicine administration.
Risks to people's health, safety and well-being had been assessed and detailed plans were in place for staff to follow in order to keep people safe. People told us they felt safe with the staff who supported them and family members told us they were confident their relatives were well looked after.
Accidents, incidents and safeguarding concerns were recorded and acted upon appropriately. Systems were in place to ensure that learning was taken from incidents to prevent them occurring in the future.
There were enough staff available to ensure that people received their care within the agreed times. People and family members told us staff arrived on time and completed all the tasks they were required to complete. Safe recruitment processes were in place to ensure new applicants were safe to work for the service.
Staff had received training in infection, prevention and control and the provider had systems in place to ensure infection outbreaks were managed effectively.
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.
Improvements had been made since our last inspection. Positive feedback had been received from people, family members and staff about the manager and the overall service provided by ICare (GB) Limited-Knowsley.
Meetings were held with staff to provide them with important information about the service. The manager and provider had worked closely with the local authority to drive necessary improvements to people's care and support.
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 requires improvement (published 8 July 2021) and there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of some regulations.
Why we inspected
We carried out an announced focused inspection of this service on 25 and 30 March 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, staffing and governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
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 remained requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for ICare (GB) Limited-Knowsley on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to medicines management and governance. 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.