Careful Care Limited

Updated 14 July 2021

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 Care Act 2014.

This was a focused inspection to check whether the provider had met the requirements in relation to Regulation 12 (Safe care and treatment) and Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

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

This inspection was announced.

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 3 June 2021 and ended on 9 June 2021. We visited the office location on 3 June 2021.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service and three relatives about their experience of the care provided. We spoke with the provider and registered manager and communicated with nine members of staff (both by telephone and email)

We reviewed a range of records. This included four people’s care and medication records. We looked at two 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 reviewed.

After the inspection

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

Updated 14 July 2021

About the service

Careful Care Limited is a domiciliary care service providing personal care to people in their own homes. At the time of the inspection 69 people were supported with their personal care needs.

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

At our previous inspection in November 2020, we found that effective systems were not being used to manage people’s risks and monitor the quality of care being provided. Records relating to people’s care and staff recruitment were not always complete and contemporaneous.

However, during this inspection, we found the provider had acted on our feedback and implemented their action plan and the regulatory requirements were now being met. There was evidence that the provider had improved their processes to assist them in the monitoring of people’s care.

Each person’s care needs had been comprehensively reviewed and documented. Staff had access to the information they needed to support people and the actions they should take to help mitigate and monitor people’s personal risks. Medicine care plans described people’s prescribed medicines and creams and dosages.

People reported that safe infection control practices were used when they were supported by staff. Staff had access to personal protective equipment and were aware of their responsibility to minimise the spread of infections.

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.

Systems to safely recruit staff had been reviewed and implemented. People were supported by sufficient numbers of staff who had been vetted and assessed as being of good character and competent before they provided care to people.

The registered manager worked in partnership with people, their families and health care professionals to achieve good outcomes for people and sought their feedback.

Quality assurance systems had been reviewed and developed to assist the registered manager in the monitoring the quality of care being provided and the management of staff. However further time was needed to ensure that the systems implemented were fully embedded and that their quality assurance findings were recorded in more detail such as the observations of staff care practices.

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 January 2021) and we identified two 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 improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

We carried out an announced focus inspection of this service on 11,12,13 November and 8 December 2020. Two 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 in relation to safe care and treatment and good 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 ‘Is the service Safe and Well-led?’ which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. 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 Careful Care Limited on our website at www.cqc.org.uk.

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.