Zach's Care

Updated 9 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

This inspection was carried out by 1 inspector. An Expert by Experience also spoke to relatives on the telephone about their experience of the care provided. 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 homes.

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.

What we did before the inspection

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 sought feedback from the local authority and professionals who work with the service.

During the inspection

We spoke with 3 people who used the service and 7 relatives about their experience of the care provided. We spoke with 4 staff including the registered manager. We reviewed 20 people's care records. We looked at 3 staff files in relation to recruitment practices. We reviewed various records relating to the management of the service including training records, safety checks, incidents and accidents.

Updated 9 August 2023

About the service

Zach's Care provides personal care to people living in their own homes. The service provides care for people with diverse needs, including people living with dementia, mental health conditions and support needs relating to mobility. Not everyone who used the service received personal care. 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. At the time of our inspection, 22 people using the service received a regulated activity.

People’s experience of using this service and what we found

People did not always receive their prescribed medicines safely. Risks to people, such as falls, health conditions and emotional distress, were not always safely managed. People were protected from abuse, staff were recruited safely, and enough staff were deployed to meet people's needs.

People were not always supported to have maximum choice and control of their lives as the provider had not always ensured they worked in line with the principles of the mental capacity act. People were not always supported in the least restrictive way and in their best interests. the provider’s policies aligned with the principles of the mental capacity act, however the provider had not always implemented this effectively.

Care plans were not promptly implemented when people started to use the service and did not always provide person-centred information about meeting peoples’ needs and preferences. However, staff received training induction and supervision. People were supported to access healthcare services.

People told us staff treated them with respect and dignity. Staff promoted people's independence by ensuring people were offered choices. People told us the service was caring.

End-of-life care planning had not yet been considered for people. Information was not always available to staff about meeting people's communication needs. Systems were in place to respond to complaints effectively, and people felt confident about raising concerns.

The provider had not operated effective systems to monitor the safety of people's medicines and follow up on related concerns. Available sources of information were not used effectively to ensure risks to people were well managed. However, people and their relatives felt positive about their experience of the care provided. Staff were regularly engaged with and supported. The provider was open and honest and worked well in partnership with others.

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. We considered this guidance as there was a person using the service who had a learning disability and or autism.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 22 February 2022, and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement and Recommendations

We have identified breaches in relation to safe care, person centred care, consent and good governance at this inspection. 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.