11 and 13 May 2015
During a routine inspection
The inspection was announced and took place on 11 and 13 May 2015.
Guardian Angel Carers Ltd is a domiciliary care agency that provides personal care and support to people in their own homes in Chichester and the surrounding area. People who receive a service may include those living with dementia, physical disabilities and sensory impairments. At the time of this inspection the agency was providing a service to 81 people. Visits ranged from half an hour up to six hours. The frequency of visits ranged from one visit per week to four visits per day depending on people’s individual needs. The agency also provides live-in carers for people and overnight care.
During our inspection the registered manager was present. 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.
Medicines were not managed safely. The records in place did not demonstrate that people had received their medicines as prescribed. There were gaps in the records and some care workers practice had not been observed. At times, the agency had not followed its own medicines policies and procedures.
Assessment and care planning processes did not ensure people’s legal rights were upheld with regard to consent. Care workers had not been provided with enough training about mental capacity and consent.
Care workers understood local safeguarding procedures. They were able to speak about the action they would take if they were concerned that someone was at risk of abuse. Where concerns had been raised, the registered manager had reported these promptly to the local authority. However, the registered manager had not notified CQC.
People were asked for their views on the service provided and understood how to make a complaint if necessary. Ten of the 12 people that we spoke with said that the registered manager and the provider responded promptly to their concerns.
People’s care had been planned and individual support plans were in place. Where risks had been identified these were assessed and actions had been agreed to minimise them. People received support to prepare meals and, where necessary to eat and drink. If people required input from other healthcare professionals, this was arranged. Staff often supported people to attend GP or hospital appointments.
People who used the service felt they were treated with kindness and said their privacy and dignity was always respected.
The registered manager and the provider were committed to continuous improvement and feedback from people, whether positive or negative, was used as an opportunity for improvement. There were processes in place to monitor quality and understand the experiences of people who used the service.
Staff were highly motivated and proud of the service. They said that they were fully supported by the registered manager and a programme of training and supervision that enabled them to provide a quality service to people.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of the report.