Anglia Care

Anglia Care is a domiciliary care service providing personal care to people living in their own homes. The service provides support to adults.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our inspection there were 109 people receiving the regulated activity of personal care.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

There had been recent changes in the management of the service. The provider and management team had identified areas for improvement, but these had not yet been fully implemented or embedded in practice. The systems in place for monitoring and assessing the service were not fully established to ensure shortfalls were identified and addressed in a timely way. This included the lack of documented actions taken to show how shortfalls in staff practice, recording and feedback received was addressed.

Records relating to people’s care and support required improvement, there were inconsistencies and some information out of date. To address the shortfalls, a new electronic care planning system was being rolled out and all people’s care needs were being reviewed and documented.

The systems to plan people’s care visits needed improvement to ensure they were managed to support staff with time to travel between visits and stay for the planned amount of time. We received feedback from people and relatives that staff were not always skilled to support them in the way they needed and preferred.

There were systems in place to reduce the risks of abuse and avoidable harm. Support provided with medicines was monitored and actions taken where discrepancies were identified. Staff received training in infection control and processes were in place to monitor staff.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 29 September 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We received concerns in relation to the care provided, medicines management and visit times. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Anglia Care on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to deployment of staff and governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At our last inspection of 22 January 2015 the service was rated Good. At this inspection we found the service remained Good.

There was 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 service continued to provide a safe service to people. This included systems designed to minimise the risks to people, including from abuse. There were systems in place to make sure that there were enough care workers to cover people’s planned care visits. Robust recruitment procedures were in place. Where people required support with their medicines, this was done safely.

Care workers were trained and supported to meet people’s needs. The service understood the principles of the Mental Capacity Act 2015 and people were supported to have maximum choice and control of their lives and care workers cared for them in the least restrictive way possible; the policies and systems in the service supported this practice. Systems were in place to support people to eat and drink enough, where they required support. People were supported to have access to health professionals where needed.

Care workers had good relationships with people who used the service. People’s views and preferences were listened to and acted on about how they wanted to be cared for and supported.

People received care and support which was planned and delivered to meet their individual needs. A complaints procedure was in place and complaints were acted upon and used to improve the service.

The service continued to have an open and empowering culture and quality assurance systems supported the management to identify shortfalls and address them promptly. As a result the quality of the service continued to improve.

Further information is in the detailed findings below.