Chinite Resourcing Limited is a domiciliary care agency, which provides personal care and support to people in their own homes, from daily visits to 24 hour live in care. At the time of the inspection there were 15 people using the service. We carried out an announced comprehensive inspection of this service on 17, 18, 21 November 2016. The provider was given 48 hours' notice of our visit because they provide a domiciliary care service and we needed to be sure staff would be available at the location to meet with us.
We reported that the registered provider was in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were:
Regulation 9 Regulated Activities Regulations 2014 - Person centred care
Regulation 11 Regulated Activities Regulations 2014 - Dignity and respect
Regulation 12 Regulated Activities Regulations 2014 - Safe care and treatment
Regulation 16 Regulated Activities Regulations 2014 - Complaints
Regulation 17 Regulated Activities Regulations 2014 - Good governance
Regulation 18 Regulated Activities Regulations 2014 - Staffing
Regulation 19 Regulated Activities Regulations 2014 – Fit and proper persons
Regulation 18 Registration Regulations 2009 – Notification of other incidents
The overall rating for this service was 'Inadequate' and the service was therefore placed in 'Special Measures'. Services in special measures are kept under review and, if we have not taken immediate action to propose to cancel the registered provider's registration of the service, we will inspect them again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.
We took enforcement action and served a Notice of Decision putting conditions on their registration which told them they must not take on any more people to provide care for and must not agree to increase the level of personal care being provided to current people using the service, without our written agreement. Additional conditions placed on them were that they report to us about how they recruited staff, arranged the staff rotas, checked the competency of the staff and how their quality assurance systems checked that care plans and risk assessments reflected the needs of the people who used the service.
We sent an urgent action letter requesting information and an action plan. We gave the provider until 24 November 2016 to ensure they complied with the Notice of Decision. The provider sent us a comprehensive plan with the actions they intended to take.
At this inspection in May 2017, we found the service had made significant improvements and that all the breaches of the regulations found in our visit in November 2016 had now been met. The provider had also met the conditions which we had imposed on them and had embraced the opportunity to learn from the mistakes made and embed the necessary improvements. In order for these improvements to be sustainable in the longer term, we have proposed to keep two of the conditions, (staff rota arrangements and quality assurance), in place which we will review at a later date.
The service had a registered manager in place. 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.
The registered manager had revised the risk assessments and care plans to ensure they were aware of how to support people to remain safe in their homes and to be as independent as possible.
There were sufficient staff to meet people’s needs and to manage risk safely. Improvements had been made to the checks carried out on new staff to ensure recruitment was robust and safe.
The registered manager and staff had taken steps to ensure that accurate medicines records were maintained and improved checks helped ensure people were receiving the medicines they needed.
Staff had access to relevant training and regular supervision to equip them with the knowledge and skills to care and support people effectively. Staff were kind and caring and treated people with dignity and respect.
The legal requirements of the Mental Capacity Act 2005 (MCA) were followed when people were unable to make specific decisions about their care. The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves.
Support with food and drink of people’s choice was provided and records kept if staff had concerns. Staff worked in cooperation with health and social care professionals to ensure that people received appropriate healthcare and treatment in a timely manner.
Systems to monitor the quality of the service had been implemented which had improved the quality of the service which people received. These included systems to support people if they wished to complain or raise concerns about the service. The provider had appropriately notified the Care Quality Commission of any significant events as required by law.
Effective management systems had been put in place from lessons learnt which included a firm infrastructure, strong leadership and a staff team with the skills and knowledge to manage the service into the future and sustain the improvements made.