Coldbrock Healthcare

Coldbrock Healthcare is a domiciliary care agency. It provides personal care to people living in their own houses and flats. At the time of our inspection 16 people were receiving a regulated activity.

At the time of the inspection 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

The registered manager and provider had implemented quality assurance and monitoring systems to improve the outcomes for people. However, these systems were not fully embedded and were not fully effective, including at addressing the shortfalls we identified on inspection. More time was needed to allow whole service improvement and sustained good outcomes for people.

Improvements were made to the recruitment processes. However, more improvements were needed to ensure the provider operated safe staff recruitment practices.

Since our last inspection, the registered manager and provider had ensured risks to people's care were fully assessed, planned, or documented.

People and their relatives were complimentary about the support they received. Comments included: “I find the carers quite good we can have a laugh and a joke with them. They are very polite and friendly.” and “Mum’s happy with the care and the carers she has a good laugh with them.”

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 25 August 2022).

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 improvements had been made, however the provider was still in breach of the regulations.

Why we inspected

We carried out an announced focused inspection of this service on 04 July 2022 and 08 July 2022. 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 and good governance.

We undertook this focused inspection to check whether the Warning Notices we previously served in relation to Regulation 17, and requirement notices in relation to Regulation 12 and Regulation 19 Care Quality Commission (Registration) Regulations 2009, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. We also received information of concern in relation to people's personal care since our last inspection.

This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements. For the key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service remains requires improvement. This is based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Coldbrock Healthcare on our website at www.cqc.org.uk

Enforcement and Recommendations

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 monitor the service and will take further action if needed.

We have identified continued breaches in relation to staff recruitment and good 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.

Coldbrock Healthcare is a domiciliary care agency. It provides personal care to people living in their own houses and flats. At the time of our inspection 19 people were receiving a regulated activity, increasing to 21 people by the time we completed our inspection.

At the time of the inspection 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 the service and what we found

The care provided was not always safe. Risks to people's care were not fully assessed, planned, or documented. Government guidance in relation to Covid-19 staff testing was not being adhered to. Safe recruitment practices were not always followed.

We identified widespread shortfalls in the way the service was managed. The provider failed to implement effective processes to assess and monitor the quality of the service and to identify the issues found during our inspection. An example was a failure to have an effective system in place to monitor the length of visits, delivering care at the scheduled times and identifying missed care visits. There were also issues with recording of complaints and concerns and gaining feedback from people in relation to the quality of their care.

People received support from a consistent staff team that knew them well. People and relatives shared mixed feedback about the care provided. One person said, “I am very grateful that they take care of me”. Another person said, “If they don't come or are very late I have at times had to lower [person’s] bed right down in case [person] falls out if I have to leave [person] alone urgently for something.”

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, report published 2 April 2021.

Why we inspected

The inspection was prompted in part due to concerns received about people's safety and the management of the service. A decision was made for us to inspect and examine those risks.

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

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 safe care and treatment, safe recruitment and good governance at this inspection.

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.

Coldbrock Healthcare is a domiciliary care and sheltered living service providing personal care to people living in their own houses and flats. The service supported 3 people at the time of the inspection. The service was only operating the domiciliary care service at the time of the inspection.

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

People and their relatives were positive about the caring nature and approach of staff. They told us they felt safe when staff visited and were confident that any concerns would be dealt with promptly. The service had employed appropriate numbers of staff to deliver the care and support people required.

Appropriate measures had been implemented to minimise and manage risk to people. Where people were supported with medicines, they were supported by staff who had received appropriate training and medicines were managed safely.

Infection prevention measures had been established within the service. Staff had a good understanding of these procedures and people confirmed staff were wearing protective equipment when visiting people in their homes.

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.

People received care which had been developed in partnership with them and their representatives. People and relatives told us their opinions had been considered when developing their care plans. Where people were supported with their nutritional needs, they told us staff offered them a choice as to what they would like to eat and took their preferences into account.

Staff had received training which was appropriate to their role. Staff told us they received regular support from management. Staff told us they could seek advice from the registered manager. The service communicated and engaged with others such as family members to improve the lives of people who used the service.

The registered manager acted on concerns to ensure people received care which was safe and responsive to their needs. Any concerns or accidents were reported and acted on.

The registered manager had developed a variety of quality assurance systems to monitor the overall quality of the service provided to people.

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 was registered with us on 16/04/2019 and this is the first inspection.

Why we inspected

This was a planned 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.