Independent People Homecare is a domiciliary care agency providing support to people in their own home. The service provides a live-in care service to people in the community. At the time of our assessment the service was supporting 30 people. The service had a manager registered with the Care Quality Commission. This means they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. We reviewed 20 quality statements under the safe, effective, caring, responsive and well-led key questions. We undertook this assessment to follow up on breaches of regulation identified at our last inspection. At this assessment improvements had been made and the provider was no longer in breach of regulation.
PDF cached but not yet analysed by Claude; set ANTHROPIC_API_KEY and re-run npm run etl:reports -- --location 1-10852858707.
Independent People Homecare improved from Inadequate to Requires Improvement and exited Special Measures, with Effective rated Good but continued breaches of regulations 12, 13 and 17 around safeguarding, safe care and governance. Missed care calls, unsafe medication management, failure to escalate safeguarding concerns and weak oversight of sub-contracted staff and finances placed people at risk of neglect.
Concerns (13)
criticalSafeguarding: “We found serious complaints that had been raised by people or their relatives had not been referred to the local authority safeguarding team for an independent investigation and review.”
criticalMissed or late visits: “missed calls had been identified in May, June and September placing people at risk of not receiving the support they needed.”
criticalMedication management: “Two people were not supported with their medication over a period of a weekend due to missed calls. This placed them at serious risk of harm due to not receiving their prescribed medication.”
criticalIncident learning: “The provider had identified the need to implement an electronic call monitoring system following an episode of calls being missed. However, at the time of inspection this had not been implemented.”
criticalGovernance: “The provider and registered manager failed to have good governance systems in place. This was a continued breach of regulation 17 (Good Governance).”
moderateCare planning: “Risk assessments were in place but did not always contain all the information needed to support people appropriately.”
moderateStaff training: “The relieve carer had been given no training on how to administer insulin.”
moderateStaffing levels: “they had continued to find recruitment difficult leading to shortages with staff to provide care and support to people.”
moderateComplaints handling: “where some complaints should have been escalated to a safeguarding investigation which had not been done.”
moderateRecord keeping: “Part of this risk assessment was to keep records and receipts for money spent, we found no records had been kept.”
moderatePerson-centred care: “a person's choice of whether received care from a male or female member of care staff was frequently disregarded even when they raised a complaint about this.”
moderateCommunication with families: “We get the obligatory monthly phone call but it's so generic and nothing happens even when issues are raised.”
minorConsent / capacity: “where best interest decisions were in place these needed to be less generic.”
Strengths
· Service no longer in Special Measures following improvements since previous Inadequate rating
· Effective key question improved from Inadequate to Good
· Staff received training in person and online, with two training managers and 'train the trainer' upskilling
· Competency assessments in place for medication and moving and handling
· Appropriate recruitment checks completed including DBS, references and work history
Quality-Statement breakdown (19)
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Using medicines safelyNot rated
safe: Learning lessons when things go wrongNot rated
safe: Staffing and recruitmentNot rated
safe: Preventing and controlling infectionNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Supporting people to live healthier lives, access healthcare services and supportNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
caring: Ensuring people are well treated and supported; respecting equality and diversityNot rated
caring: Supporting people to express their views and be involved in making decisions about their care; Respecting and promoting people's privacy, dignity and independenceNot rated
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesNot rated
responsive: Meeting people's communication needsNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: End of life care and supportNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirements; duty of candour; Continuous learning and improving care; Working in partnership with othersNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empowering; Engaging and involving people using the service, the public and staffNot rated