Mace Homecare Service Ltd is a domiciliary care agency registered to provide personal care to people in their own homes. The service provides support to people of all ages and different abilities. At the time of this assessment, they supported 3 people who received personal care. The Care Quality Commission (CQC) only inspect the service received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. We conducted this assessment to follow up on concerns we identified at the last inspection. These included a breach of Regulation in relation to safe care and treatment. The last rating for this service was requires improvement (published 29 November 2022). At this assessment we found improvements had been made and the provider was no longer in breach of regulation. Assessment activity started on 12 May 2025 and ended on 23 May 2025. There was a registered manager in post. A registered manager is a person who has registered with the CQC to manage the service. This means that they and the provider are legally responsible for how the service operates. We assessed quality statements from the safe, caring and well-led key questions. The overall rating for the service has improved from requires improvement to good. Risks associated with people’s care had been identified and managed to help keep people safe.People received their medicines as prescribed. Safeguarding procedures were in place to help protect people from abuse and poor care. Staff told us they felt confident to speak up and felt they would be supported to do so. Staff were recruited safely and had the necessary skills, training and support to carry out their role. Governance systems were in place and the registered manager had oversight over the running of the service. Management obtained feedback from people using the service. Where people raised issues, the registered manager was responsive and took action to put things right.
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Prime Healthcare Services Limited, a newly registered domiciliary care agency in Harrow, was rated Requires Improvement overall at its first inspection in October 2022, with one breach of Regulation 12 identified due to ineffective risk assessment processes that left some people at risk of unsafe care. While caring, effective and responsive practices were rated Good, governance and quality assurance systems were not yet sufficiently embedded to identify and address safety deficiencies.
Concerns (5)
criticalRecord keeping: “Risks to people were not always assessed effectively and this meant people were at risk of receiving unsafe care and treatment. This is a breach of Regulation 12.”
moderateCare planning: “Information in people's care plans was task-focused and lacked person specific instructions about how they wanted their care to be delivered.”
moderateGovernance: “The service's checks and audits had failed to identify the issues found with regards to risk assessments.”
minorIncident learning: “The template did not include a section for recording details about the immediate actions taken, the outcome and any follow up actions and lessons to be learnt.”
minorEnd-of-life care: “Care plans did not evidence a discussion surrounding end of life wishes had been considered.”
Strengths
· Recruitment processes helped to ensure that care workers assessed as safe to work with people were employed.
· Appropriate medicines management and administration processes were in place.
· People were protected from abuse; staff had received safeguarding training and were confident in escalating concerns.
· Staff followed infection prevention and control guidance including appropriate use of PPE.
· People were supported to have maximum choice and control; MCA principles were followed.
Quality-Statement breakdown (22)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Learning lessons when things go wrongRequires improvement
safe: Staffing and recruitmentGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesRequires improvement
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportRequires improvement
well-led: Managers and staff being clear about their roles, understanding quality performance, risks and regulatory requirements; continuous learningRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Engaging and involving people using the service, the public and staff; working in partnership with othersGood
well-led: How the provider understands and acts on the duty of candourGood