Icare Solutions (Wirral) Ltd

Updated 27 April 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

This inspection was completed 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.

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 unannounced.

During the inspection

We spoke with two people using the service and five relatives. We spoke with the nominated individual and three office support staff. We reviewed care records for eight people and multiple medicines records. We also reviewed service records, including staff records for six care staff, quality and safety monitoring records, as well as policies and procedures.

After the inspection

We spoke with six staff providing care to people in the community. We also reviewed further evidence provided by the nominated individual electronically. This included the service improvement plan, staff training records and other management records.

Updated 27 April 2022

ICare Solutions (Wirral) Ltd is a domiciliary care agency providing personal care to people in their own homes. At the time of our inspection there were 78 people using the 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

There had been improvements to the quality and safety of the service. The provider now had oversight of risks when providing care for people and steps to mitigate these risks. These improvements were recent since the previous inspection in June 2021 and needed to be embedded and sustained over a longer period of time.

Medicines were managed safely and records of administration were accurately completed, however some call times did not allow for assurance that medication was administered as prescribed.

Where people required support to take their medicines, staff supporting them were trained in medicines and their practice was checked by the provider during spot check visits .

People did not always receive support at the scheduled times, for the planned length of time. This had a negative impact for some people, on the quality of care they received.

People had individualised care plans in place that were used to assess the risks identified in their care. These had been updated since our previous inspection. However, we found that they did always provide staff with guidance on how to care for people safely.

Staff also received induction when they first started in post, and the provider ensured they were competent for their roles before supporting people on their own. This had been updated since our previous inspection.

People and relatives told us that the service had improved since the previous inspection. They described how the service was now more reliable and having regular staff had a positive impact on their care.

There were enough staff to support people, which minimised risks to people who had consistent support allocated. Most staff told us they felt supported in their roles and people and their relatives found staff competent and kind. This has improved since our previous inspection.

The provider had ensured safe recruitment practices were now being followed fully.

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 Inadequate (published 26 July 2021). At this inspection we found that although some improvements had been made, the provider remained in breach of regulations regarding the management of medicines, risk management and the governance of the service.

Why we inspected

We carried out an unannounced inspection on 3 and 10 March 2022 following on from breaches that were found at the previous inspection in July 2021. The provider completed an action plan after the last inspection to show what they would do and by when to make improvements.

We undertook this focused inspection to check improvements had been made and if the provider 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 comprehensive inspection to calculate the overall rating. The overall rating for the service has changed from inadequate to 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 Solutions (Wirral) Ltd 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 care and treatment, staffing and the governance of the service at this inspection. You can see what action we have told the provider to take at the end of this full report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Special Measures

The overall rating for this service is ‘Requires improvement’. However, the service remains in 'special measures'. We do this when services have been rated as 'Inadequate' in any Key Question over two consecutive inspections. The ‘Inadequate’ rating does not need to be in the same question at each of these inspections for us to place services in special measures. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.