Homecare1st

Updated 4 November 2022

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

The inspection was carried out by two inspectors and an expert 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 houses and flats.

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 a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 7 September 2022 and ended on 23 September. We visited the location’s office on 7 September 2022

What we did before the inspection

We reviewed notifications and information we had received about the service since the last inspection. We contacted the local authority for feedback regarding 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 plan our inspection.

During the inspection

We spoke with four members of staff including the registered manager, deputy manager, office administrator and office assistant and contacted 14 care staff and received feedback from four. We reviewed a range of records. This included nine people’s care records and multiple medicines records. We looked at 14 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 4 November 2022

About the service

Homcare1st is a domiciliary care agency providing support to people in their own homes. People with various care needs can use this service including people with physical disabilities, older people and people with dementia. At the time of inspection, 30 people received personal care 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

Medicines were not always handled and recorded correctly and safely. The providers recruitment of staff did not always include the required information. The visits were scheduled using an online system and this was overseen by the registered manager. People and relatives felt the staff supported them well. However, some improvements could be made regarding timings of the visits.

People reported they felt safe with the staff providing their support and care. Staff understood their responsibilities to raise concerns and report incidents or allegations of abuse. The staff team followed procedures and practices to control the spread of infection using personal protective equipment. People’s risks were assessed and managed effectively.

The provider did not ensure systems were in place to oversee the service and ensure compliance with the fundamental standards. They did not ensure the Care Quality Commission (CQC) was informed of notifiable incidents in a timely manner.

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 20 February 2021).

Why we inspected

We undertook a targeted inspection to follow up on specific concerns received about the service. The inspection was prompted in part due to concerns received about the recruitment of staff and staff training. A decision was made for us to inspect and examine those risks.

We found there was a concern with the recruitment of staff and ensuring staff received all mandatory training prior to providing care to people. Therefore, we widened the scope of the inspection to become a focused inspection looking at the key questions of safe and well-led.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Homecare1st on our website at www.cqc.org.uk.

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 monitor the service and will take further action if needed.

We have identified breaches in relation to safe recruitment of staff, notifications of incidents, management of medicines, risk assessments 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.