Archived: Avocet Healthcare Ltd

The service is a domiciliary care agency. Avocet Health Care provides support to people who require support with daily tasks and personal care in their own homes. Not everyone using the service receives the regulated activity of personal care. 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 take into account any wider social care provided.

At the time of our inspection, there were five people receiving personal care from the service.

The service had 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 care homes, 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.

People and relatives told us they felt safe when receiving care and support from the service. Staff were knowledgeable about the risks to people’s health and welfare and clearly described how they minimised the likelihood of occurrence. However, care records required further development to document robustly the actions required.

Staff had completed training in safeguarding of adults and were aware of their responsibilities for keeping people safe, and reporting incidents of abuse. Incidents and accidents were recorded, reviewed and lessons learnt to improve the service.

People were supported by sufficient numbers of staff who were appropriately checked to ensure they were suitable to work at the service. People’s medicines were administered as the prescriber intended, however staff were not clear on when they were required to administer these. People were protected from the risk of infection when care was provided as staff followed clear guidance.

Care plans were based on the assessed needs of people, which meant that people received personalised care and support. People felt staff were sufficiently trained to support them effectively and staff felt supported by the registered manager. Staff were provided with regular supervision sessions, however, they had not been able to further develop their skills or knowledge.

Staff understood the principles of the Mental Capacity Act 2005 (MCA) and people’s capacity to make decisions was assessed when required. They encouraged and promoted people's rights to make their own decisions about their care.

Staff supported people with nutrition and hydration, when needed.

Staff were kind, caring and passionate about their roles. Staff maintained people's privacy and treated them with respect and dignity. People told us they had good support, from staff who provided them with care that met their needs and preferences. People told us the care they received responded to their needs and felt valued by the staff who cared for them. People told us that staff supported them to maintain links in their community, show and interest in them and encourage them to participate in activities.

There was a clear complaints procedure in place. People knew how to make a complaint if they had concerns.

People and staff felt the service was well led. The views of people were sought about the quality of care provided, however, the registered manager did not formally seek the views of their staff or relatives. Since the previous inspection, improvements had been made in some areas, however, we found progress in achieving these required actions was not within a reasonable time frame and required further improvement. We found that although the registered manager had carried out their own review of the quality of care within the service, this did not address some of the areas we identified and brought to their attention.

There was a registered manager in place. A registered manager is a person who has registered with the CQC 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.

When we contacted the service to announce our visit we were informed that the service was being provided from a different location to that registered with CQC. The manager who was also the Nominated Individual had not informed us of this change. This meant that the provider was in breach of the conditions of their registration. We asked the manager to rectify this and shortly after this inspection CQC received an application from the provider to request changes to correct their registration.

We found t two 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.

People did not consistently have robust risk assessments, which identified and explored all the risks which people faced. Staff recruitment checks were not fully completed to ensure staff were suitable to work in the care sector.

People were protected from experiencing harm and abuse by staff who were knowledgeable about how to do this. Staff were aware of the potential signs of abuse. The service had systems in place for staff to respond to concerns.

Staff and the manager responded to accidents and incidents involving people who used the service. However, there was a lack of recording systems in place to evidence the action taken.

Staff received regular training and an induction to their roles when they started working at Avocet Health Care. However, the ways the manager checked staff’s competency were not robust. Also, the manager did not always have an effective system to check staff had understood the training provided.

People were supported to make choices with their daily care needs. People were supported to have enough to eat and drink. Staff raised health concerns with people and passed any concerns onto the director who made contact with people’s relatives.

We had mixed views about whether new staff were consistently caring towards people, but on the whole, the people and their relatives we asked were positive about the staff.

People’s care assessments and reviews were not always centred on them as individuals. These records did not demonstrate people had been fully involved and asked about their views of their care in a meaningful way. However, people’s care plans were detailed records guiding staff about people’s daily care needs.

The manager was not completing audits to assess the quality of the care provided, and putting plans in place to make timely improvements. We found issues with elements of the governance of the service which the manager was not aware of until we inspected Avocet Health care.