Archived: Abicare Services Limited - Dorset

At our last inspection in December 2015 we found the service was not meeting the requirements of the regulations and highlighted six breaches of the regulations. The following breaches of the regulations were highlighted; people were not protected against the risks associated with the unsafe management and use of medicines, risks to people’s health and safety whilst receiving care had not been assessed, checks had not been consistently carried out to ensure that staff were suitable to work with vulnerable people, care workers were not supported with regular training, supervision and appraisal and effective systems and processes had not been established to assess and monitor the quality and safety of the service provided and accurate records were not maintained. Following our inspection the provider wrote to us to tell us what improvements they would implement to ensure they would become compliant with the regulations. At this inspection the provider was compliant with the regulations.

Abicare Services Limited - Dorset, provides personal care and support to people who live in their own homes. At the time of our inspection they were providing personal care and support to 52 people.

The service is required by law to have a registered manager, and there was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Generally people were content and happy with the service they received. People were provided with support and care by a team of staff who knew them and understood their care and support needs well.

People felt safe with the care staff and staff knew the correct procedures on how to respond and report potential abuse.

Staff received training, which was refreshed at regular intervals, to ensure they had the skills and knowledge they required to be able to provide care safely. There was an on-going programme of staff supervision meetings and appraisals to ensure staff performance was monitored regularly. Staff were provided with support and guidance to carry out their role effectively.

Care plans and people’s support records were clearly written, reviewed and kept up to date when changes occurred.

There were safe systems in place to administer and manage people’s medicines.

There was a robust recruitment system in place to ensure people were cared for by staff who had been recruited safely. There were sufficient staff employed with the right skills and knowledge to meet people’s needs.

People’s rights were protected because staff and management had a working knowledge of the Mental Capacity Act 2005.

Environmental risk assessments were completed on people’s homes to ensure any risks to staff and people were minimised.

Quality assurance systems were in place to monitor and where necessary improve the quality of service being delivered.

The focus of the inspection was to follow-up on two compliance actions made at the last inspection of the agency in July 2013.We used the information to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Abicare Services Ltd Dorset provides approximately 716 hours of care a week to people in the Dorset and surrounding areas and employs about 27 members of staff.

We spoke with two members of staff as well as the managers. We also liaised with the local authority about their perspective of the service provided by the agency.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

At the last inspection in July 2013 we found that care plans were not always in place before staff began providing care and support to people. This meant there was a risk that staff would not know the care and support that had been agreed to be provided.

At this inspection we found that there were systems in place to make sure care plans and risk assessments were in place within 72 hours, making sure staff were provided with the information they needed before starting to provide care and support to people they visited.

Is the service effective?

At this inspection we found that action had been taken to make sure that care plans were in place in a timely way. We also found that action had been taken to make sure there was consistency in how topical creams were recorded when administered by the staff. This ensured that people had creams administered as prescribed by their GP.

Is the service caring?

At the last inspection of the agency in July 2013 we found the service was caring with people being treated with dignity and respect by the staff. People spoke positively about the care they had received. We have not received any concerns since that time about the care and support provided to people.

Is the service responsive?

At this inspection we did not look at outcome areas against which we could assess the responsiveness of the agency, as we were only checking the agency had made the improvements we required at the last inspection.

Is the service well led?

Since the last inspection there have been three changes of manager. The current manager agreed that an application to register as manager of the agency would be submitted within a week of the inspection.

Staff we spoke with told us that since the new locality manager took over running the office in May 2014 things had improved. The staff told us that the running of the office was more organised and that they felt better supported.

Before the inspection we received information of concern that the agency had experienced some staffing problems in early July. We found that they were taking appropriate action to manage this. People who used the service told us that the service they received was reliable. For example, one person commented, "They come when they say they are going to come", while another person said, "They are very good time-keepers."

People said that the care workers who visited them were well trained and knew what they were doing. They had confidence in their care workers to meet their needs and ensure they were safe. We found that the agency had arrangements in place to provide training and support to care workers. However, there were some gaps where this had not been implemented fully over the past year. At the time of our inspection, the agency was putting plans in place to ensure that all staff received appropriate support in their roles.

We asked people about their care and support. People were positive about the care and support they received. One person told us that the staff were 'very good, they would do anything for you'.

We found people's needs were assessed and care and treatment was delivered in accordance with their individual care plan. We looked at six people's care records and found that each had an up to date care plan and risk assessments. The care plan and risk assessments were reviewed regularly and reflected the needs of the individuals.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines although there were areas for improvements relating to the recording of medication administered.

We found there were enough qualified, skilled and experienced staff to meet people's needs.

The provider had an effective complaints system available and we found comments and complaints people made were responded to appropriately.