14 June 2023
During a routine inspection
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.