Background to this inspection
Updated
25 December 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.
Inspection team
The inspection was carried out by one inspector.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
We gave a short period 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.
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.
During the inspection
We spoke with four relatives about their experience of the care provided. We spoke with two members of staff including the registered manager and the provider.
We reviewed a range of records. This included five people’s care records and medication records. We looked at one staff file 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. We looked at training data and quality assurance records.
Updated
25 December 2021
About the service
Kingfisher Domiciliary Homecare Limited is a domiciliary care service providing personal care and support to older people and younger adults with mental health needs, physical disabilities or sensory issues, living in their own homes. At the time of the inspection 5 people were being supported with personal care.
People’s experience of using this service and what we found
People at Kingfisher Domiciliary Homecare Limited did not always receive a safe and well led service.
The provider had not effectively operated their quality assurance systems to oversee the safety and quality of the service. However, this did not appear to have a negative effect on people using the service.
There were shortfalls in the quality of recording of information. We have made a recommendation about this.
An effective system was not in place to ensure government guidance was adhered to in relation to the management of risks associated with COVID-19. We have made a recommendation about this. The registered manager put procedures in place immediately following the inspection to ensure guidelines were being followed.
Recruitment records were not always completed accurately. We have made a recommendation about this.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible or in their best interests; policies and systems in the service did not support this practice. We have made a recommendation about this.
Medicines were not always managed safely. The provider had not effectively monitored the administration of medicines and failed to provide guidance to staff on how and when to administer ‘as and when required medication’ (PRN.) We have made a recommendation about this.
We expect health and social care providers to guarantee autistic people and people with a learning disability
the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. People were supported to reach their personal goals due to the person-centred
approaches, and staff having the right skills and attitudes to achieve this.
People received person centred care. Relatives spoke positively about the care people received and the registered manager. They felt able to raise concerns and were confident that these would be addressed. Staff knew people well and were knowledgeable about when to refer to other health professionals for advice and support.
Staff provided a consistent, reliable service. Staff developed and implemented individualised risk assessments which mitigated risks to people's safety and wellbeing. Care plans covered all aspects of people's lives and their preferences. People received care from staff who were well trained and knowledgeable.
Systems were in place for communicating with people, their relatives and staff to ensure they were fully involved.
This service was registered with us on 05/03/2020 and this is the first inspection.
Why we inspected
This was a planned inspection based on this being the first inspection.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took into account of exceptional circumstances arising as a result of COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of the 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 poor quality assurance and safety monitoring systems.
Full information about CQC’s regulatory response to more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.