FCNA Homecare, a homecare service based in Ashley Road, Hale, has been placed in special measures after the Care Quality Commission (CQC) found multiple legal breaches during a follow-up inspection. The service received an 'inadequate' rating, the lowest possible, following concerns that were first raised in 2023 when it was rated 'requires improvement'.
Legal Breaches Identified
The CQC inspection revealed that FCNA Homecare was in breach of three legal regulations relating to consent, safe care, and good governance. Inspectors found that information for safe medicine management was not consistently available, including up-to-date medicine lists and procedures for medications given as needed. For people with swallowing risks, the team could not ensure medications were administered in line with clinical guidance.
According to the CQC, these gaps 'reduced assurance that medicines were managed safely and that risks were monitored and acted on in a timely and consistent way'.
Concerns Over Health Monitoring and Consent
There was also limited evidence to show how staff recognised early signs of changes in users' health, including deteriorating conditions, and how these were monitored. Inspectors could not be sure potential health risks were 'consistently identified and acted upon in a timely way'.
Insufficient evidence was found regarding the assessment of people's mental capacity, how decisions were made for those people, how consent was 'sought and respected in line with legal requirements', and how people's rights were upheld. FCNA Homecare told inspectors there was no 'established process' in this area. The CQC stated: 'This limited assurance that decisions were made lawfully, proportionately, and in line with people's rights.'
Record-Keeping and Recruitment Failings
Failings in record keeping for service users meant staff 'did not have reliable, current information to share, and people could not be confident that written information reflected their actual needs'. The report noted 'notable differences' in how various groups experienced the service, with people under 65 and those with learning disabilities reporting 'substantially lower satisfaction scores than others'. However, there was no evidence of review, analysis or follow-up to understand and address the causes.
Significant gaps were also found in recruitment processes, including missing induction records, references and employment histories. These missing pieces were not identified by internal audits. Evidence of medicine competency and mental capacity and best interest training was also missing, meaning the provider could not show 'how staff were enabled to deliver safe or legally compliant care', the CQC added.
Inaccurate Information and Positive Feedback
Statutory information about the service was also inaccurate, including the provider operating from an address that was not the registered location. Despite these failings, service users and relatives said care was 'generally reliable and consistent' and staff were 'kind, respectful and compassionate'. People said staff 'supported them in ways that made them feel safe and comfortable'.
The Local Democracy Reporting Service approached FCNA Homecare for a comment but did not receive a response.
