This inspection took place on 19 and 20 January 2016 and was announced. The provider was given 48 hours’ notice because the location provides domiciliary care service and we needed to be sure that someone would be at the office.iCall Care Office is a domiciliary care service providing care and support to people living in their own homes. The office is based in the city of Leicester and the service currently provides care and support to people living in Leicester. At the time of our inspection there were 26 people using the service who received personal care and social support.
A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People told us they felt safe with the staff that supported them. Staff were trained in safeguarding (protecting people who used care services from abuse) procedures and were confident to report concerns about people’s safety to the registered manager.
People’s safety was not protected because staff were not recruited properly and pre-employment checks were not carried out. Improvements were also needed to staff training, supervision and support because the systems were not in place to monitor and support staff effectively.
Risks to people health and safety in relation to the care and support they needed was not assessed properly. Measures to manage risk were not always detailed sufficiently in the plan of care. People’s care was not monitored or reviewed regularly and changes to their needs were not always acted upon. This meant that people received unsafe or inappropriate care.
The service had sufficient staff to meet people’s needs. People’s individual requirements were matched where possible, with any known requirements such as individual preferences, cultural or diverse needs.
People were prompted to take their medicines by staff where people’s assessed needs and care plans required this. Staff supported people to liaise with health care professionals if there were any concerns about their health.
People told us that staff sought consent before they were helped and that staff always respected their choices and decisions. However, improvements were needed to ensure the registered manager and staff understood their responsibilities and requirement to protect people under the Mental Capacity Act and Deprivation of Liberty Safeguards.
People had limited opportunity to be involved in decisions made about their care and their views about the quality of service provided. People did not always receive person centred care that was responsive to help maintain their health, safety and wellbeing.
People’s privacy and dignity was maintained, their choice of lifestyle was respected and their independence was promoted.
People were confident to raise any issues, concerns or to make complaints. However, the provider’s complaint procedure was not transparent and concerns raised were not recorded. Improvements to the service were limited as a result of a complaint.
There was a registered manager in post. The provider policies and procedures had clear guidance, tools and documentations to be used to ensure a quality and safe service was provided but these were not followed. The provider’s quality governance and assurance systems were fragmented and ineffective. Confidential information relating to the people who used the service, staff and the management of the service were destroyed. There was no evidence to demonstrate that the provider monitored, reviewed, and took steps to make improvements to the service. Therefore, improvements were needed.
We found six breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.