Archived: Angels @ Home C.I.C.

Updated 9 May 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was carried out by two Adult Social Care inspectors from the Care Quality Commission (CQC)

Service and service type

Angels @ Home C.I.C is a domiciliary care agency. Not everyone using the service receives a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The service had a manager registered with the CQC. The registered manager was also the sole director and the provider which means they were the only person legally responsible for how the service was run and for the quality and safety of the care provided.

CQC had taken previous enforcement action following the first comprehensive inspection at the service in February 2017 and changed the condition of registration requiring the sole director to appoint a registered manager so that there was additional oversight at the service. Since February 2017, there have been three managers appointed and commenced the registration process with CQC but subsequently left the service within a short timeframe. A fourth manager was appointed in October 2018 and they had commenced the process of registering with CQC.

We also imposed a condition preventing the service taking new or increasing current care packages. To do this, Angels @ Home C.I.C required prior agreement from CQC.

Notice of inspection

The inspection was unannounced.

We visited the office location on 27 November 2018 and 29 November 2018 to see the manager and office staff; and to review care records and policies and procedures. We made calls to people receiving a service on 03 December 2018.

What we did:

Prior to the inspection we reviewed any notifications we had received from the service. A notification is information about important events which the service is required to tell us about by law. We also reviewed any information about the service that we had received from external agencies. We reviewed the action plan that we had requested prior to our meeting in July 2018. We used this information to inform our inspection planning.

This inspection included speaking with eight people, one relative, five members of staff, the registered manager/provider and the newly appointed manager. We reviewed records relating to the care of five people and their medicine records. We reviewed six staff recruitment files, supervision and appraisal records. We looked at records relating to the management of the service, staff Rotas, call logs, policies and procedures, safeguarding, quality assurance and complaints.

Updated 9 May 2019

About the service:

Angels @ Home C.I.C is a domiciliary care agency, which provides personal care and support to people in their own home. At the time of the inspection, there were 32 people using the service.

People’s experience of using this service:

The culture at the service was poor. Carers were not meeting people’s care needs. Staff were late to care visits and didn’t stay with people for the required duration of time. Staff had remained for two minutes of a 30-minute call and were not completing care tasks as detailed in people’s care plans.

The registered manager who was also the sole director of Angels @ Home C.I.C lacked oversight and was implicit in what was occurring at the service. They were implicated in falsifying documentation to indicate they had completed a care visit when another carer had attended.

The registered manager and sole director was responsible for devising the staff Rota’s which had the same staff member scheduled to visit four different people at the same time.

Angels @ Home C.I.C recruitment policy had not been adhered to and safe recruitment procedures were not followed. Staff were identified as working independently with people in their own home prior to their DBS check being received.

People had been placed at risk of harm because risk assessments and care plans were not representative of people’s assessed needs.

Staff had not received appropriate up to date training to meet people’s needs safely. There were staff working at the service that had not completed a care qualification and no identified timeframe to do so.

Systems and processes were ineffective to manage the service which had resulted in breaches of the regulations.

Rating at last inspection:

The service was last inspected 27 and 28 February 2018 and was rated as requires improvement. The report was published 03 May 2018. Following the last inspection, we met with the registered manager and sole director of Angels @ Home C.I.C in July 2018 and asked them to complete an action plan to show what they would do and by when to improve the key questions safe, effective, caring, responsive and well-led to at least ‘Good’. They had failed to achieve this and the quality of care people received had significantly deteriorated.

Why we inspected:

The inspection was brought forward because we had received information indicating that staff were attending to people singularly when the person required two carers. Staff were alleged to be falsifying documentation and recording that two carers had attended the visit and people were being charged as if two carers had attended.

It was substantiated during a safeguarding strategy meeting 20 November 2018 that staff had attended two carer calls alone. It was also substantiated that a staff member had falsified documentation by pre-entering in the home report log a care visit that had not yet occurred.

Enforcement

We undertook enforcement action to cancel the registration of the provider and registered manager. Action to cancel the service and registered manager's registration was completed on 24 April 2019.

Follow up:

Following the inspection, we made safeguarding referrals to the Local Authority to look in to our immediate concerns regarding people’s safety.

On 14 March 2019, everybody that was still receiving a service from Angels @ Home C.I.C was supported by the local authority to move to an alternative care provider to receive their care and support.

The service was rated ‘Inadequate’ and the service placed in ‘special measures’. The Care Quality Commission (CQC) has now completed the enforcement action taken following our November 2018 inspection to cancel the provider and the registered managers registration. This concluded and the CQC register was updated on 24 April 2019.