Background to this inspection
Updated
8 July 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
This inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave a short period notice of the inspection because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We received feedback from two professionals. We looked at all the information we had collected about the service including previous inspection reports and notifications the registered manager had sent us. A notification is information about important events which the service is required to tell us about by law. We used all of this information to plan our inspection.
During the inspection
We spoke with four people who used the service and seven relatives about their experience of the care provided. We received written feedback from four members of staff. We spoke with the registered manager and the compliance and audit manager.
We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at four staff files in relation to recruitment and staff supervision. We reviewed a variety of records relating to the management of the service, including incident and accident records, quality assurance records, policies and procedures, staff training records, medicines audits and staff meeting minutes.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at staff interview records and evidence of communications between the registered manager and social services. We reviewed evidence of training and competency reviews for senior staff members. We also spoke with a social worker regarding the service.
Updated
8 July 2021
About the service
Aaron Abbey Care Services Limited is a domiciliary care agency. It provides a service to people living in their own homes in Berkshire. Not everyone using the service receives personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
At the time of this inspection staff were providing personal care to 13 people, including older and younger adults, some of whom may be living with dementia, physical disabilities and sensory impairments.
People’s experience of using this service and what we found
At the last inspection we found medicines were not always managed safely. At this inspection we found medicines were not always managed safely. Audits had not identified errors and omissions in people’s medicines electronic administration records (e-MARs).
Risks to people were assessed and documented. However, care plans did not always contain specific instructions for staff about how to protect people from identified risks.
At the last inspection the registered manager had not established effective systems and processes to monitor quality and safety in the service. At this inspection the registered managers systems for monitoring quality and safety were still not effective. Audits had failed to identify omissions and errors in people’s e-MARs, as well as the lack of specific instructions for staff about how to protect people from identified risks and the inaccuracies in people’s care plans.
At the last inspection the registered manager had failed to comply with the conditions of their registration to submit monthly action plans at a set time and date addressing compliance with the regulations 8 to 20. This was an offence of section 33 of the Health and Social Care Act 2008.
We issued a fixed penalty notice to the provider which was paid. Following this the registered manager submitted monthly action plans on time.
Enough improvement had been made and the registered manager was no longer in breach of this regulation.
At the last inspection the registered manager did not have an effective system for monitoring late or missed visits. At this inspection the registered manager used an effective system to monitor late or missed visits.
People felt safe in the care of staff and were protected from the risk of getting an infection.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff completed training to support people with their identified needs.
People had caring relationships with staff who promoted their privacy, dignity and independence. People’s views were sought by the provider.
Staff reflected on accidents and incidents to prevent recurrences. Staff worked with professionals from health and social care to support people’s health and wellbeing.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was requires improvement published 14 October 2019) and there were breaches of regulation. The service remains rated requires improvement. This service has been rated requires improvement for the last five consecutive inspections. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
Enforcement:
We have identified a repeated breaches in relation to regulation 17 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Systems and processes used to monitor quality and safety in the service were not always effectively used to ensure the service met the required fundamental standards of care.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Since the last inspection we recognised that the provider had failed to comply with a condition submit monthly action plans to us. This was a breach of regulation and we issued a requirement to the provider. The provider accepted a fixed penalty and paid this in full.
Follow up:
We will meet with the provider to discuss how they will make changes to ensure they improve their rating to at least good. We will follow up on issues that we identified by asking the registered manager to send us evidence of how and when the issues will be resolved. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
You can see what action we have asked the provider to take at the end of this full report.