Archived: Cera Worcestershire

Updated 23 July 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

The inspection team consisted of one inspector. We visited the service on 22 April 2021. We gathered further information about the service via telephone conversations. We spoke with people and their relatives to gain feedback about the service and had telephone conversations with care staff.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The registered manager was in the process of leaving the company so was not available during the inspection. Homecare4U had recently been acquired by a new management team but was continuing to operate as Homecare4U. A new manager has been appointed who is in the process of registering with CQC.

Notice of our inspection

Our inspection was announced.

We gave short notice of our visit on 21 April 2021 to the newly appointed manager. Notice of our visit was given because the service was inspected during the coronavirus pandemic and we wanted to be sure we were informed of the service's coronavirus risk assessment for visiting healthcare professionals before we entered the building, and to ensure the provider was available for their inspection. Inspection activity commenced on 22 April 2021 and ended on 7 May 2021.

What we did before the inspection

We reviewed the information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work in the service. 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

During our on-site visit to the service, we spoke with the new appointed manager, area manager and three members of care staff. We reviewed a range of records, including safeguarding records, staff records and records relating to the governance of the service.

After the inspection

We spoke with seven people who used the service and two relatives. We spoke with six members of care staff. We also reviewed the care plans and risk assessments for five people that used the service and reviewed additional documentation that we had requested from the provider.

Updated 23 July 2021

About the service

Homecare4U Worcestershire is a domiciliary care agency. People had individual packages of care in their own homes. At the time of this inspection Homecare4U supported 53 people with personal care. 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.

People's experience of using this service and what we found.

People and relatives told us care staff often turned up late or early and that at times they were not informed that calls were going to be late. Care staff told us that there was not enough time between calls to ensure that they could arrive in time.

People did not always receive safe care. Risks assessments were not updated to reflect current risks to people’s safety. Where risks were identified by care staff this was not communicated to everyone that needed this information to keep people safe.

There was no system to monitor call times and the manager did not know when care staff arrived and left. Staff did not consistently log into calls at the time calls were being made. This meant the manager could not establish if people received their agreed care.

Care staff had knowledge of safeguarding and whistle blowing; however, care staff did not always feel supported to raise concerns. Safeguarding procedures had not always been effectively followed. There were examples where actions that should have been taken to keep people safe but were not always taken in a timely manner.

Safe recruitment procedures were not always followed. The registered manager had identified one member of care staff as needing additional supervision and checks to provide assurances as to their suitability for the job. This was not completed, and no assurance could be provided to what actions had been implemented to ensure this care staff member’s suitability.

There was no effective governance or oversight of the service or how it was performing.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Rating at last inspection: At the previous inspection in December 2019 the service was rated Good in all areas. At this inspection we have rated this service as requires improvement in Safe, Effective and Well Led. This leads to an overall rating of requires improvement.

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

Why we inspected

We received concerns in relation to the management of risks and safeguarding. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe, effective 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.

Enforcement

We are mindful of the impact of the Covid-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the Covid-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of our 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 identified breaches in relation to the management of risks associated with people’s care, recruitment procedures, notifications and governance of the service at this inspection.

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 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.