Background to this inspection
Updated
1 June 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
The inspection was carried out by 2 inspectors, and 2 Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The Expert by Experience’s made telephone calls to people and their relatives on the first day of the inspection.
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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.
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 we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 14 April 2023 and ended on 3 May 2023. We visited the location's office on the first day.
What we did before the inspection
We reviewed the information we held about the service. 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 also gathered feedback from the local authority. We used all this information to plan our inspection.
During the inspection
We visited the office and spoke with the registered manager, senior care staff and care staff. We spoke with 10 people using the service and 10 relatives of people using the service to seek their feedback on the service they received. We reviewed records, including 11 people’s care plans and risk assessments, 5 staff recruitment and training records and a variety of records relating to the management of the service, including quality monitoring systems and audits.
Updated
1 June 2023
About the service
Plum Care Ltd is a domiciliary care service providing personal care support to people living within their own homes. The service was providing care and support to approximately 77 people at the time of the inspection. These included older people, people living with dementia and younger adults.
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 were not always protected from risks associated with their care and support as risks were not always comprehensively identified, assessed, and documented within their care plans. Systems and processes in place for managing and administering medicines were not always safe. The service did not always work within the principles of the MCA. Care plans did not always identify and or reflect details of individual preferences or contain correct information about their needs, wishes and the support they needed. Care plans and records did not include information regarding people’s end of life care, wishes and preferences.
The service was not always well managed. Systems and processes in place for monitoring the quality and safety of the service were not effective in identifying the issues and concerns we found at this inspection.
We have made a recommendation to the provider that they refer to best practice and up to date guidance in relation to staff recruitment and to ensure there are systems in place to monitor this. We have made another recommendation that regular audits of their ECM (electronic call monitoring) data are undertaken to ensure any identified themes and trends relating to people receiving their calls when requested are promptly addressed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 18 July 2019).
At this inspection, we have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Responsive and Well Led sections of this report. You can see what action we have asked the provider to take at the end of this full report.
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 person-centred care, need for consent, safe care and treatment, and good governance. We have also made two recommendations.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standard 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.