About the service Sensiway Care Services is a domiciliary care service. It provides care for people living in their own houses and flats. People are supported in their own homes so that they can live as independently as possible. CQC regulates the personal care and support. There were two people who received personal care 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
Care staff had not always had the required pre-employment checks completed when they had been appointed to work at Sensiway Care Services. There had not always been enough care staff to provide people’s care as planned. Risks were not well managed, including for risks associated with infection and COVID-19. Systems to learn lessons when things go wrong were not robust.
Staff had not received adequate training to give them the skills and knowledge they needed to effectively manage and reduce risks from COVID-19. Not all staff listed on staff rotas were included on the provider’s training matrix so we were not assured that all staff had received appropriate training. Staff supervision and appraisal meetings had not been recorded.
Systems and processes to assess, monitor and reduce risks and assess, monitor and improve the quality and safety of services were not effectively operated. Records were not always accurate, complete or contemporaneous. Business and management contingency planning was not effective.
Assessments of people’s needs were available, however these had not always been reviewed regularly. Not all details of other professionals involved in people’s care were included in their care plans. Evidence was not available to show how people, families, staff and other professionals had been asked for their views to improve the quality and safety of services.
Staffing shortages had impacted negatively on people and their families. A complaint that people had not always been treated well was under investigation by the provider. The complaints system did not always operate effectively.
Staff understood how to identify potential signs of abuse and knew what actions to take to help safeguard people. Staff understood people’s dietary needs when they were involved in providing this care. People’s preferences were known and respected. People were involved and able to make decisions over their care.
People’s independence was promoted. People received personalised care and their communication needs were met. People were supported in ways to reduce the risk of social isolation. The provider had notified others when they were unable to provide the planned number of staff.
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.
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 10 June 2020 and this is the first inspection at this location. The service changed address and the last rating for the service under the previous address was requires improvement, published on 28 March 2020. The service has now been rated inadequate.
Why we inspected
This was a planned inspection based on the date of registration.
We have found evidence that the provider needs to make improvement. Please see the safe, effective, caring, responsive 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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Sensiway Care Services on our website at www.cqc.org.uk.
Enforcement and Recommendations
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 monitor the service and will take further action if needed.
We have identified breaches in relation to recruitment of staff, safe care and treatment and the management and governance of the service 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 meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.
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.