Phemacare Ltd

Updated 31 May 2023

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.

Inspection team

The onsite inspection was carried out by 2 inspectors on the first day and 1 inspector on the second day.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. At the time of the inspection there were 4 people using the service.

Registered manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

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 would be in the office to support the inspection.

Inspection activity started on 08 March 2023 and ended on 15 March 2023. We visited the office location on 08 March and 13 March 2023.

What we did before the inspection

We reviewed information we had received about the service since it registered with CQC. We sought feedback from the local authority and professionals who work with the service.

The provider did not complete the required Provider Information Return (PIR). This is information providers are required to send us annually with key information about the service, what it does well and improvements they plan to make. Please see the well led section of the full inspection report for further details.

We used all of this information to plan our inspection.

During the inspection

We spoke with 3 people who used the service about their experience of the care provided. We spoke with 7 members of staff including the registered manager, the operations manager, the branch manager and 4 care staff.

We reviewed a range of records. This included 4 people’s care records and medication records for 2 people. We looked at the 4 staff members’ files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 31 May 2023

About the service

Phemacare Ltd is a is a domiciliary care agency providing personal care to people in their own homes. The service was supporting 4 people with personal care at the time of our inspection.

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 provider's recruitment practices required improvement to ensure people are supported by suitable staff. The small staff team in place knew people well but care records such as care plans and risk assessments needed more information to give staff clear up-to-date guidance for managing people’s risks.

The provider had not followed their own policy in the administration of medication. When people required creams to be applied detailed records for staff to follow were not in place.

Staff adhered to infection control procedures and protected people from the risk of infection. Staff had completed safeguarding training and felt able to raise concerns; however, we found some staff required improved knowledge in safeguarding adults' procedures.

Checks and audits in place had failed to identify the areas for improvement found at this inspection including safe recruitment processes, care planning and risk assessments and medication records. The provider also needed to establish an audit system to monitor calls times and call duration to ensure people were receiving their assessed and required care.

The provider had not completed the last two Provider Information Returns (PIRs). This is information providers are required to send us annually with key information about the service, what it does well and improvements they plan to make.

People we spoke with said staff provided good care and staff working for the provider told us they felt supported.

The provider took immediate action in response to some of the areas we identified as requiring improvement and planned to take further action following the inspection.

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 04 December 2020), there was a breach of regulation and a warning notice was issued. At this inspection we found the provider was still in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service and to look at actions taken by the provider following the last inspection.

We undertook a focused inspection to review the key questions of safe and well-led only.

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 remained as requires improvement based on the findings of this inspection.

Enforcement

We have identified breaches in relation to fit and proper persons employed and governance systems at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.