15 & 22 April 2015
During an inspection looking at part of the service
Abbeyfield Domiciliary Care Agency operates only within the Abbeyfield Independent Living with Extra Care complex, which is located close to Ilkley town centre. The agency is part of an integrated care scheme providing supported living for people aged 55 and above and operates a 24 hour service.
The agency provides care and support to people in 42 separate flats with a wide range of needs including people who have dementia, physical disabilities or whose health is in some way impaired.
We inspected the service on the 15 & 22 April 2015. The provider was given 48 hours’ notice because the location provides a domiciliary care service. Our last inspection of the service took place on the 21 November 2013 and at that time we found the agency was meeting all regulations we looked at.
At the time of inspection there was not a registered manager in post as they had resigned in February 2015. However, an interim manager had recently been appointed to manage the service until the vacancy was filled. 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.
We found the organisation’s staff recruitment and selection procedures were not robust which might lead to people receiving their care and support from staff unsuitable to work in the caring profession. We also found staff had not received the training support they required to carry out their roles effectively and in people’s best interest.
However, the staff we spoke with were able to describe how individual people preferred their care and support to be delivered and the importance of treating people with respect in their own homes. People who used the service and their relatives told us staff were very caring and always provided care and support in line with their agreed support plan.
The provider had policies and procedures relating to the safe administration of medicines in people's own homes which gave guidance to staff on their roles and responsibilities. However, following concerns raised by other healthcare professionals the interim manager was reviewing the policy to ensure it was specific to the needs of people who used the service and followed national guidelines.
There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or treatment they received. The people we spoke with told us they were aware of the complaints procedure and would have no hesitation in making a formal complaint if they had any concerns about the standard of care provided. However, we found not all complaints had been recorded correctly which made it difficult to establish if they had been dealt with in line with procedure in place.
The provider had started to introduce a more robust quality assurance monitoring system that continually monitored and identified shortfalls in service provision. However, the provider and interim manager were aware that more work was required before the systems in place were fully operational and consistently applied.
The Chief Executive Officer, Operations and Compliance Manager and Interim Manager all acknowledged the current service shortfalls, but detailed the recent changes that had begun to be implemented which were not yet fully embedded at the time of the inspection.
We found three breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.