You are here

Reports


Inspection carried out on 16 November 2016

During a routine inspection

This inspection was announced and took place on 16 and 17 November 2016. We told the provider 48 hours before our visit that we would be coming to ensure that the people we needed to talk to would be available.

Agape Care Solutions has 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.

Agape Care Solutions provides personal care and support to people who live in their own homes. At the time of the inspection they were providing over 200 hours per week to nine people living in Dorset.

At our previous inspection in April 2016 we found a number of shortfalls and issued warning notices with regard to the assessment and provision of care and the management of medicines, the safe recruitment, training and supervision of staff. We found further shortfalls in the management if risks, protection of people from abuse, governance and record keeping. Requirement notices were issued in these areas. The service was rated inadequate overall and placed in special measures. This comprehensive inspection was carried out to ensure that the service had met the requirements of the warning notices and made improvements in the other areas that had been identified.

At this inspection we found that the service had taken all of the required actions and no breaches in the regulations were found. This means that the service will no longer be in special measures. This was because the registered manager had stepped back from working as a member of care staff as well as managing the service and had concentrated on putting policies and procedures in place, updating staff training and ensuring that the service was providing the quality of care and support that was required by people.

People told us their care and support needs were met and that staff were kind, caring and respectful. People also said they felt safe and had confidence in the staff that worked for the service.

Staff knew people well and understood their needs. Care plans were detailed and regularly reviewed. This meant that there was always information for staff to refer to when providing care for people.

The provider had implemented satisfactory systems to recruit and train staff in a way that ensured that relevant checks and references were carried out and staff were competent to undertake the tasks required of them. The number of staff employed and the skills they had were sufficient to meet the needs of the people they supported and keep them safe.

People were protected from harm and abuse wherever possible. There were systems in place to reduce and manage identified risks. Staff understood how to protect people from possible abuse and how to whistle-blow. People knew how to raise concerns and complaints and records showed that these were investigated and responded to.

There was a clear management structure in place. People and care staff said was the managers were approachable and supportive. There were systems in place to monitor the safety and quality of the service.

Inspection carried out on 31 March 2016

During a routine inspection

This inspection was announced and took place on 31 March and 5 April 2016. We told the provider one day before our visit that we would be coming to ensure that the people we needed to talk to would be available.

Our last inspection was in October 2013 during which we found shortfalls in the way people’s care was assessed, planned and delivered, medicines management, and staff recruitment, training and supervision. Compliance actions (now known as requirement notices) were issued. The provider submitted an action plan following that inspection which covered all of the required areas and stated the service would be compliant by 30 May 2014. During 2015 the service moved to a new location. At this inspection we found that the service had failed to rectify the previous breaches in regulations and also found additional breaches.

Agape Care Solutions provides personal care and support to people who live in their own homes. At the time of our inspection they were providing personal care to 17 people.

Agape Care Solutions has 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. The registered manager was only available for the second day of the inspection. When they were not present, the compliance manager was available and answered many of our queries.

People said that staff knew them well and understood their needs. They told us their care and support needs were met and that staff were kind, caring and respectful. People also said they felt safe and had confidence in the staff. However, care plans were not always sufficiently detailed or up to date to provide information and instruction for staff particularly if they did not know the person they were caring for.

People’s medicines were not always managed safely. Policies and procedures did not follow current national guidance and staff had not been properly trained. This meant that people may not have received their medicines as they were prescribed.

The service did not always manage the risks to the health and safety of the people they provided care to. Risk assessments were not always fully completed. Where risk assessments had been completed, some identified hazards but no action had been taken to reduce or manage the hazard and some were in need of review because situations had changed or accidents had happened and not been taken into account.

Management arrangements and systems at the service did not ensure that the service was well-led.

Staff had been recruited and allowed to work with people before the required checks had been undertaken to ensure that they were suitable to work with vulnerable people. Staff had also not been adequately trained and supervised.

Quality monitoring systems were not used effectively because they had not identified all of the shortfalls highlighted during this inspection. Some records contained errors and omissions.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘Special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

You can see what action we told the provider to take at the back of the full version of the report.