Assured Care Formby

Assured Care Formby is a domiciliary care agency providing care to people living in their own homes, so they can live as independently as possible. At the time of our inspection the service was supporting 49 people with personal care. Not everyone who used the service received 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.

People's experience of using this service and what we found

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted.

Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Right support: Some people were not supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.

We have made a recommendation about how the provider can work more in line with the principles of the MCA (Mental Capacity Act.)

Right care: Although people told us they received person-centred care and care which promoted their dignity, privacy and human rights, further information was required in care plans to help provide further guidance for staff, such as information about their preferences and interests. At the time of our inspection, not all staff had received specific training to aid the support of people living with autism/and or a learning disability.

Right culture: The ethos, values, attitudes and behaviours of leaders and care staff did not always ensure people using services lead confident, inclusive and empowered lives. Staff knew people well and were able to deliver person-centred care, but the oversight of the service was ineffective and inconsistent.

Medicines were not always managed in a safe way. We were not assured people had their medicines as prescribed. Staff hadn't always had their competency assessed to ensure they were able to administer medicines safely.

Oversight and governance processes did not always assure the delivery of safe and high-quality care. Some audits were not completed routinely or at all. The registered manager had failed to fully address the concerns found at the last inspection.

Information about risk was not always properly reviewed or up to date. People’s care plans required further information to manage risks effectively.

Staff were not always recruited in a safe way. References had not always been sought.

We have made a recommendation about recruitment practices.

Although people told us they received care and support which was person centred to them, care plans did not always reference best evidence guidance and lacked accurate and consistent information.

People and their relatives told us they were happy with the support they received. We also received positive feedback from staff about their experiences of working for the service. It was clear staff had formed genuine and positive relationships with the people they supported.

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 (report published 17 March 2023). The service remains rated requires improvement. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found although some improvements had been made, the provider remained in breach of some regulations.

At our last inspection we recommended that the provider sought advice and guidance from a reputable source on supporting people's communication needs and updated their practice accordingly. At this inspection we found the provider had acted on our recommendation and had added information about communication needs to people’s care plans.

Why we inspected

We carried out an announced comprehensive inspection of this service on 11 January 2024. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, consent, person centred care, staffing, fit and proper persons employed and good governance.

We undertook this comprehensive inspection to check they had followed their action plan and to confirm they now met legal requirements. We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

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.

At this inspection we found the provider remained in breach of regulations 12 and 17.

We have made recommendations about the need for consent (regulation 11) and fit and proper persons employed (regulation 19).

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Assured Care Formby is a domiciliary care agency providing care to people living in their own homes, so they can live as independently as possible. At the time of our inspection the service was supporting 84 people with personal care.

Not everyone who used the service received 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.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Right support: Some people were not supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Right care: Care and support did not always reflect current evidence-based guidance, standards and best practice to meet the needs of autistic people and people with a learning disability. The planning of care was not person-centred and did not reflect people’s preferences, interests, likes and dislikes.

Right culture: The culture of the service did not focus on ensuring people were involved in planning their care. Staff knew people well and were able to deliver some elements of person-centred care, but this was inconsistent. There was a lack of manager oversight.

Medicines were not managed or administered safely. Medicines records did not detail people’s support needs and medicines administration records were not always completed in line with best practice guidance. Staff hadn’t always had their competency assessed to ensure they were able to administer medicines safely.

Recruitment processes were not safe. Details of staff’s full employment history were missing, and references had not always been sought.

Risks to people’s health and welfare were not always adequately assessed or managed. Risk plans were lacking in detail to guide staff on how to safely support people.

Oversight and management at the service was ineffective. Audits were not completed routinely, and the registered manager failed to identify and address concerns.

People and their relatives told us they were happy with the support they received. They told us staff were caring and kind in their interactions. However, they told us they did not always feel involved in the planning of their care, and they did not always know they had a care plan.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 24 May 2021 and this is the first inspection.

Enforcement and recommendations

We have identified breaches in relation to the management of medicines, risk assessing and risk management, person-centred care, consent, governance, recruitment processes and staff training at this inspection.

Please see the action we have told the provider to take at the end of this report.

We have made a recommendation about supporting people’s communication needs.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.