Background to this inspection
Updated
5 August 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 Health and Social Care Act 2008.
Inspection team
The inspection was carried out by 1 inspector and 1 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 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 or registered manager would be in the office to support the inspection.
Inspection activity started 14 June 2023 and ended on 23 June 2023. We visited the location’s office on 14 June 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with 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
During the inspection, we spoke with 3 people using the service, 7 people's relatives, 4 staff members, the care coordinator, and the registered manager. We reviewed a range of records relating to people's care and the way the service was managed. These included care records for 4 people, medicine administration records, staff training records, 3 staff recruitment files, staff supervision records, quality assurance audits, incidents and accidents, complaints and compliments records, and records relating to the management of the service.
Updated
5 August 2023
About the service
Healthcare Access Ltd is a domiciliary care agency providing care to people in their own homes in the Oxfordshire area. At the time of our inspection 19 people were receiving the regulated activity of personal care from the service.
Not everyone using the service received personal care. CQC only inspects where people receive personal care, which is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
At the time of the inspection, the location did not provide personal care for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.
People’s experience of using this service and what we found
Right Support: People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests.
Right Care: People, and their relatives were happy with the care they received from the service. People felt staff members were friendly and treated people with kindness and warmth.
Right Culture: Care plans contained detailed information about people, their likes and dislikes, however, did not always contain information specific to people's needs or how to manage conditions or risks as appropriate documentation was not always in place.
The provider did not operate effective quality assurance systems to oversee the service. These systems did not identify shortfalls in the quality and safety of the service.
Risk assessments were not always updated to accurately reflect people's risks. There was conflicting information about people’s ability, and health conditions within their risk assessments.
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 good (13 December 2021)
Why we inspected
The inspection was prompted in part due to concerns received about the service relating to care plans, staffing and medicines. A decision was made for us to inspect and examine those risks.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
We have found evidence the provider needs to make improvements. Please see the safe, effective, responsive, and well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Healthcare Access Ltd Oxford on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to regulation 11 consent for care, regulation 12 safe care and treatment, regulation 14 meeting nutritional and hydration needs, and regulation 17 good governance.
Please see the action we have told the provider to take at the end of this report.
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 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.