Background to this inspection
Updated
23 June 2023
We carried out this performance review and assessment under Section 46 of the Health and Social Care Act 2008 (the Act). We checked whether the provider was meeting the legal requirements of the regulations associated with the Act and looked at the quality of the service to provide a rating.
Unlike our standard approach to assessing performance, we did not physically visit the office of the location. This is a new approach we have introduced to reviewing and assessing performance of some care at home providers. Instead of visiting the office location we use technology such as electronic file sharing and video or phone calls to engage with people using the service and staff.
Inspection team
This inspection was carried out by 1 inspector and 1 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 houses and flats.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was not a registered manager in post. However, the owner had applied to become registered and was acting as manager in the interim.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because the service is small and we wanted to be sure there would be someone available to support this inspection.
Inspection activity started on 3 May 2023 when we began to review evidence using remote methods such as file sharing and video calls and spoke with people. The inspection ended on 1 June 2023 when we gave feedback about the inspection findings to the manager.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, Healthwatch England and professionals who work with the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all this information to plan our inspection.
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection
We spoke with 2 people and 4 of their relatives. We spoke with 3 members of staff including the nominated individual who was acting as manager. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed 3 people’s care records and medicine records. We reviewed 2 staff recruitment records and various other quality assurance documents and policies.
This performance review and assessment was carried out without a visit to the location’s office. We used technology such as video calls to enable us to engage with people using the service and staff, and electronic file sharing to enable us to review documentation.
Updated
23 June 2023
About the service
Azelea Care Solutions is a domiciliary care agency providing personal care to people. The service provides support to older people and younger adults. They also offer support to autistic people and people living with a learning disability. At the time of our inspection there were 6 people using the service.
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.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
At the time of the inspection, the location did not provide care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.
People’s experience of using this service and what we found
People did not always have all risks assessed to ensure they were safe. This had not been identified in a timely way by the provider. The impact of this was reduced due to staff knowing people well and understanding all their needs and what to do if they were concerned.
Despite our findings, people told us they felt safe and were well supported by staff. People were safe as they received a continuity of care from the same staff teams who knew them well. Staff had received training in safeguarding adults and had a good understanding of the signs and symptoms of abuse. Staff knew how to report concerns and were confident to do so.
People received their medicines on time and correctly. Staff worked with local health professionals to ensure people had the right medicine and health support at the right times.
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 had a good understanding of the Mental Capacity Act and how to support people to make decisions or report concerns of capacity where people's abilities had changed.
Staff supported people to have enough to eat and drink and to access a range of health professionals as they required it.
People told us staff were kind and caring and never rushed them. Staff supported people to review their care needs regularly involving their relatives and health professionals where relevant. People were supported to receive care that was in line with their preferred methods and needs, taking into account their abilities and cultural sensitivities.
The manager responded to complaints quickly and effectively and people told us complaints were resolved and the same issues did not reoccur.
Staff encouraged people to give feedback on the service and suggest ideas for improvements. The manager had created an open, person centred culture and a clear vision of personalised care that was shared by the staff team and experienced by people receiving care.
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 27 February 2022 and this is the first inspection.
Recommendations
We have made a recommendation about ensuring all risks to people have been assessed and have clear guidance for staff.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and video and phone calls to engage with people using the service as part of this performance review and assessment.