Cedar Oak Healthcare Services Ltd

The service is a domiciliary care agency and provides personal care to people living in their own homes. Not everyone was receiving personal care. CQC only inspects where people are receiving the regulated activity of personal care. This is help with tasks related to personal hygiene and eating. Where they do, we consider any wider social care provided. At the time of this assessment, 54 people were receiving support with personal care. There was a registered manager in post who was also the Nominated Individual. They are referred to as the provider throughout the report.

The assessment was prompted due to specific concerns received in relation to the suitability of staff and the lack of safeguarding reporting. At this assessment we found breaches of 5 regulations relating to person-centred care, safe care and treatment, safeguarding, staffing and good governance.

We were not assured that people received safe or well-managed care and identified widespread and significant concerns. A number of safeguarding concerns were identified during our assessment which had not been reported to the local authority or to CQC. This meant external agencies were unable to monitor the actions taken to ensure people’s safe care.

Not all those receiving support had full care plans and risk assessments accessible staff to guide them on how to support people safely, identify concerns and ensure these were reported.Where documentation was in place we found this to be overly complex and written in a clinical manner, making it difficult for staff to understand the support people required. Where changes occurred in relation to people’s needs, care plans and risk assessments were not always updated to provide staff with the most up to date guidance.

The provider did not share accurate information about the service with the inspection team. We therefore had concerns that they were either not being open and transparent or did not have accurate information about the people that they supported. Governance systems were ineffective and failed to identify, monitor and address the significant concerns identified at this assessment. The provider did not have a service improvement plan in place to address any concerns or ensure the service was continually developing.

Staff rotas were not always planned to ensure people received their support when they required it. Travel time was not always planned between calls. This directly correlated with the time when care calls were late or cut short.

Partner agencies told us the service was responsive to requests for support and communicated well. Health care partners were involved in people’s care, and staff reported health concerns when they arose.

This service is being placed in special measures. The purpose of special measures is to ensure that services providing inadequate care make significant improvements. Special measures provide a framework within which we use our enforcement powers in response to inadequate care and provide a timeframe within which providers must improve the quality of the care they provide.