The Care Quality Commission (CQC) has again rated Fen Homecare in Cambridgeshire inadequate and taken further action to protect people following an inspection that finished in February.
Fen Homecare, run by an organisation of the same name, is a domiciliary care agency providing personal care to people in their own homes. The service provides support to people living with dementia as well as other physical and mental health needs.
This service is also registered to support autistic people and people with a learning disability, however Fen Homecare Ltd have indicated they intend to apply to CQC for this part of their registration to be removed.
This inspection was carried out to follow up on the progress of improvements CQC told them to make at their previous inspection.
Following this inspection, the overall rating for the service, as well as the areas of safe and well-led have been rated inadequate again. Effective, caring and responsive have been re-rated as requires improvement again.
CQC has also imposed urgent conditions on the care service to restrict them from taking on new clients without prior agreement from CQC, including people returning home from a hospital stay.
The service remains in special measures which means it will be kept under close review by CQC to keep people safe and it will be monitored to check sufficient improvements have been made.
CQC has begun the process of taking regulatory action to address the concerns which Fen Homecare Ltd has the right to appeal.
Stuart Dunn, CQC deputy director of operations in the East of England, said:
“When we inspected Fen Homecare, it was disappointing that they hadn’t made the widespread improvements we told them to make at our previous inspection. We continued to identify shortfalls that compromised people’s safety and wellbeing which is why we imposed urgent conditions to prevent them taking on new clients without prior agreement from CQC.
“Poor leadership was behind a lot of the issues we found in how well care and support was delivered, documented and monitored. Without these effective processes or oversight, the service wasn’t always able to provide safe or effective care or learn from mistakes.
“Fen Homecare didn’t provide care calls to people when they said they would, in some cases was different by up to three hours. One relative shared with us that their family member had a tea call closely followed by a bedtime visit, leaving long gaps without support later in the evening. People weren't sure what time care workers would arrive each day, making it hard for them to plan their routines or eat at regular intervals and have any control in how they lived their lives.
“Leaders didn’t support staff to manage medicines safely, partly due to inadequate training. Staff gave people medication at the wrong times.
“Care plans weren’t being accurately updated meaning staff weren't able to deliver safe person-centred care that respected people’s rights and preferences.
“While most staff were compassionate and caring, some staff didn't always understand what people were asking for because of a language barrier. In some cases, staff spoke in a language people didn’t understand while supporting them, which caused them unnecessary distress and confusion.
“We’ve told leaders where we expect to see rapid and widespread improvements and we’ll continue to closely monitor the care service, including through further inspections, to make sure people are kept safe while these improvements are made.”
Inspectors also found:
- Staff rotas did not always include sufficient travel time between visits, potentially impacting the quality of care.
- Some staff had not received awareness training in managing long-term health conditions like diabetes, despite caring for people with those needs.
- Staff didn’t always record information about people’s capacity to consent consistently or correctly
- Leaders didn’t always record or respond appropriately to concerns raised by people and relatives in a timely manner.
- Staff and the registered manager failed to follow their own safeguarding processes and recognise potential safeguarding risks.
However:
- Staff supported people to access healthcare professionals or emergency support when needed.
- Some staff were kind and compassionate, taking time to build relationships with the people they supported.