Archived: Caerus Lifecare Limited

Updated 29 May 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team: This inspection was carried out by one inspector.

Service and service type: Caerus Lifecare Limited is a domiciliary care service which is registered to provide personal care and support to people living in their own home.

The service had 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 48 hours’ notice of the inspection visit because we wanted to make sure the registered manager was available on the day of our inspection.

What we did: Before the inspection, we reviewed information we had about the provider, including notifications of any safeguarding concerns or other incidents affecting the safety and wellbeing of people.

An inspection site visit took place on the 23 April 2019. It included speaking to the registered manager. We also reviewed two people's care records, which included care plans and risk assessments. We also looked at three staff files checking staff recruitment, training and supervision. We looked at records relating to the management of the service which included various policies and procedures, complaints, quality monitoring and audit information.

Following our inspection, the inspector carried out telephone interviews to obtain feedback about the service. We spoke with one person who received care from the service and a relative of another person who received care. We also spoke with two care workers.

Updated 29 May 2019

About the service: Caerus Lifecare Limited is a domiciliary care agency which provides care in people’s homes to older people. The services they provide include personal care and housework. At the time of inspection, the service provided care to four people, two of whom received personal care.

People’s experience of using this service:

The service first registered with the Care Quality Commission (CQC) in May 2018. This inspection on 23 April 2019 was the first inspection for the service.

One person who received care from the service and one relative told us they were satisfied with the level of care the agency provided and raised no concerns about safety. They spoke positively about care workers and said that they were respectful, kind and caring.

Some systems were in place to help ensure people were protected from the risk of abuse. There were appropriate policies in place with the relevant contact details. The registered manager explained that care workers had received in-house safeguarding training but there was no documented evidence to confirm this.

Risk assessments covered areas such as the environment, physical health and personal care. We however noted that there was a lack of information about control measures and action required to reduce potential risks. We raised this with the registered manager and she advised that she would review these and ensure they included further detail.

The registered manager confirmed the service did not currently administer medicines to people. We therefore did not look at how the service managed medicines during this inspection.

Feedback from one person and a relative indicated that there were no issues with regards to care worker's punctuality and attendance. However, the electronic monitoring system used by the service did not accurately document the length of time care workers provided care for. We raised this with the registered manager and she advised that she would address this shortfall.

The service had carried out employment checks, however we noted that the service had failed to obtain Disclosure and Barring checks (DBS). The DBS helps employers make safer recruitment decisions and prevent the appointment of unsuitable people. However, we noted that these had been obtained by previous employers and not by the service and were more than six months old. We found a breach of regulation in respect of this.

People received care and support from the same team of care workers. This maintained consistency and ensured that staff knew people and could build friendly professional relationships with people.

We discussed training with the registered manager. She advised that care workers had received in-house training which she had provided. However, we noted there was no documented evidence to confirm care workers had completed this training. We were therefore concerned that care workers were not sufficiently trained to provide effective care. We did not see evidence that staff had been consistently supported to fulfil their roles and responsibilities through an induction, training and regular supervisions. We found a breach of regulation in respect of this.

Details about people’s nutrition and hydration had been documented in the care plan.

People received care that respected their privacy and dignity as well as promoted their independence.

Care support plans included basic details about the support people needed with regards to various aspects of their daily life. However, we noted that the information recorded was limited and there was a lack of information about what support people wanted and how they wanted the service to provide support. We found that information in these care plans were task focused and lacked information about people's preferences. We raised this with the registered manager and she advised that she would review these and ensure that they were personalised and specific to people’s individual needs and detailed.

The service had a formal complaints procedure in place. Feedback indicated that there were no complaints about the service but people knew what to do if they needed to raise a complaint or concern.

One person and one relative we spoke with spoke positively about the management of the service. There was a management structure in place with the registered manager and a team of care workers.

The registered manager explained that she had carried out some checks, but she was still in the process of implementing these. We did not see documented evidence of comprehensive completed audits including audits of care plans, risk assessments and training.

During this inspection we identified deficiencies in relation to staff training, care plans and the electronic monitoring system. We saw no evidence that the service had identified these deficiencies and taken necessary action prior to our inspection. We raised this with the registered manager and she explained that they would make improvements to aspects of the service identified. However, we needed to be sure that these processes had been implemented consistently over a significant period of time and therefore we have rated the service as "Requires Improvement".

We found two breaches of the Health and Social Care Act 2018 (Regulated Activities) Regulations 2014.

Rating at last inspection: The service was first registered with the CQC in May 2018. This inspection on 23 April 2019 was the first inspection for the service.

Why we inspected: This was a planned comprehensive inspection that was scheduled to take place in line with Care Quality Commission scheduling guidelines for adult social care services.

Follow up: We will continue to monitor intelligence we received about the service until we return to visit as per our re-inspection programme. If any concerning information was received, we may inspect sooner.