About the service Hillcrest Community is a domiciliary care service based in Leeds, providing personal care to 23 people at the time of the inspection.
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
Consent to care forms were not always in place and mental capacity assessments (MCA) were not carried out when needed. Medicines were not managed safely, people did not always receive their medicines in the way prescribed for them. Risk assessments were not in place for people’s health conditions nor were COVID-19 risk assessments.
The provider failed to ensure safeguarding records were in place, however the provider ensured this was actioned during the inspection. Safeguarding referrals were not always being made for necessary incidents. Various areas of training including safeguarding training was not up to date for all staff members. Staff and people we spoke with told us they did not feel moving and handling practices were safe. Some training had been scheduled since the inspection.
Staff and people told us they felt the service did not have enough staff. One staff member told us, “I was really poorly yesterday and she [the manager] made me feel guilty, the manager said to me yesterday how I am supposed to cover your shift. I have been doing 16 or 18 calls a day you still get extra calls, two days ago I didn’t get a break. They don’t ask you they just give you extra calls.” Another staff member said “When we are short staffed we get extra calls and pressured and made to feel guilty to come in on our days off. I get phone calls a lot and rota changes all the time.”
At the time of the inspection the provider had not completed the correct paperwork to notify CQC they had moved location. The service was not displaying their current CQC rating, which was a legal requirement. The provider’s statement of purpose did not accurately reflect the current registration details of the managers within the service, as the service did not have a registered manager.
Care plans were not always in place and did not accurately reflect peoples care needs or health conditions. The provider and manager were working on creating and updating care plans where needed. The provider had no feedback, oversight and audit processes in place. The provider had no necessary records, reviews or actions in relation to accidents and incidents, this was put in place after our site visit. Lessons learned were not taking place when things went wrong.
Policies were not dated or signed, so we were unable to know if these had been read or when these were due for review. Their infection control policy (IPC) had not been updated since the COVID-19 pandemic. The service were providing staff with appropriate personal protective equipment. Staff supervisions were not taking place in line with the provider’s policy. Necessary background checks were not always in place when recruiting staff. Staff told us they enjoyed caring for people.
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 20 December 2019).
Why we inspected
We received various concerns in relation to this service. As a result, we undertook a focused inspection to review the key questions of safe 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 inadequate. This is based on the findings at this inspection. We have found evidence the provider needs to make improvement. Please see the safe and well-led sections of this report. You can see what action we have told the provider to take at the end of this report.
The provider has taken actions to mitigate some of the above risks, but it is too soon to know if these have been effective.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hillcrest Community on our website at www.cqc.org.uk.
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 this 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 have identified breaches in relation to consent, safe care and treatment, safeguarding, good governance and employment of fit and proper people 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.
Special Measures
The overall rating for this service is ‘inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.