Engage Care Services - Main Office Also known as Engage Care Services Limited

Engage Care Services – Main Office (known as Engage Care Services) is a domiciliary care agency providing personal care to people in their own homes. The service was supporting 71 people at the time of the inspection, including older people, those living with dementia and people with a physical disability.

People’s experience of the service and what we found:

Not all risks had been assessed. Guidance for support workers to manage risks and provide the required support was not always in place or was often brief and generic. Guidance from other professionals involved in people’s care and support was not included in the care plans for staff to follow.

Medicines were not well managed. Information about critical medicines and signs of a possible deterioration in health conditions was not recorded in people’s care plans. Where the provider was responsible for reordering people’s medicines there was no system in place to do this resulting in medicines being unavailable. Staff had access to PPE, but we were told they did not always use this correctly.

The provider’s recruitment policy was not fully followed to ensure all relevant information and checks were in place. During our inspection we were notified by the UK Visa and Immigration (UKVI) service that the provider’s licence to employ overseas workers had been suspended. UKVI are continuing their investigations and CQC are working with the relevant local authorities to ensure potential concerns for people using the service’s welfare due to UKVI’s decision.

Staff completed a range of training courses, however, there continued to be performance issues raised by people using the service, relatives, and local authorities around staff competencies. There were ongoing concerns around supporting people with personal care, maintaining people’s dignity and providing appropriate meals for people. Issues identified were not followed up with the relevant staff to improve their performance.

There were communication barriers with a large proportion of the staff team, people struggled to understand some of the support workers and they in turn weren’t able to always understand the people they were supporting or their relatives.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. The service relied on the local authority assessing people’s capacity when support was initially agreed. They did not review people’s capacity once they started receiving support. We have made a recommendation for the service to follow best practice guidance in regard to the MCA.

The provider did not have a quality assurance system in place. There were no regular audits completed and no analysis of incidents or concerns raised to reduce the risk of a reoccurrence.

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

Rating at last inspection and update

The last rating for this service was Requires Improvement (published 16 September 2022) and there was 1 breach of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations. This service has been rated requires improvement for the last two inspections.

At our last inspection we recommended the service updated their satisfaction surveys and quality assurance systems. At this inspection we found the quality assurance systems were not robust.

Why we inspected

The inspection was prompted in part due to concerns received about poor personal care, communication issues with the support workers and medicines management. A decision was made for us to inspect and examine those risks.

When we last inspected Engage Care Services breaches of legal requirements were found. This inspection was undertaken to check whether they were now meeting the legal requirements.

Enforcement and Recommendations

We have identified breaches in relation to medicines management, managing risks people may face, maintaining people’s dignity when providing care and the management of the service and staff team.

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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

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.

Engage Care Services is a domiciliary care service located in the Miles Platting area of Manchester. 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. At the time of the inspection there were 35 people receiving the regulated activity ‘Personal care’.

People’s experience of using this service and what we found

Some people said their care visits were not always on time or were too close together. Some people said they did not always feel safe as a result of the care they received. Staff were recruited safely and there were enough staff to provide people’s care. Staff carried out routine COVID-19 testing and wore personal protective equipment (PPE) as required.

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. People received enough to eat and drink and said provided assistance as needed.

Some people felt staff did not always display kind and caring behaviors and there were instances where people had not been treated with dignity and respect. Some people’s relatives raised concerns with us about how PPE was disposed of, as this was not always done safely and was not dignified.

Some people raised concerns with us that staff did not always communicate well when delivering their care and at times, spoke in a language they couldn’t understand. Some families said a copy of the care plan was not always available at the house, with an overview of the care required.

There was a complaints system in place, although some people said they did not always see sufficient improvements. People who used the service and staff provided feedback about their care through audits, surveys and meetings. Staff spoken with during the inspection told us they felt the service was well-led and enjoyed their roles. We have recommended the provider improves their quality assurance systems to ensure they provide a focus on, and continue to monitor some of the concerns from the inspection.

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 3 December 2020 and this is the first inspection.

Why we inspected

The service had not received a rating since registering with CQC. This was why we inspected.

The overall rating for the service is requires improvement. This is based on the findings at this inspection.

Follow up

We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.