We carried out a review of the data available to us about Averlea Domiciliary Care on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Averlea Domiciliary Care, you can give feedback on this service.
Averlea Domiciliary Care is a domiciliary care service providing personal care to people in their own homes. The service supports people who are primarily aged over 65 years. The service supports people primarily in the St Austell area. At the time of the inspection 20 people received support from the agency.
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.
People’s experience of using this service and what we found
The service had suitable safeguarding systems in place, and staff had received training about recognising abuse.
Risk assessment procedures were satisfactory so any risks to people were minimised.
The medicines system was managed effectively. People received suitable assistance with their medicines when the service were involved in this aspect of their care. Staff received suitable training about medicines.
Staff were recruited appropriately. For example suitable references were obtained, for example when new staff had previously worked in a caring capacity. Checks from the Disclosure and Barring Service were obtained.
Staffing levels were satisfactory. People said they received appropriate assistance with their care and were happy with the support they received.
Suitable systems were in place to minimise the risk of cross infection. Staff were provided with suitable personal protective equipment such as gloves and aprons.
The service had satisfactory assessment systems to assist the registered provider to check they could meet people’s wishes and needs before admission was arranged.
People received suitable assistance with eating and drinking, and the preparation of food when staff were involved in this area of their lives.
People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests. Policies and systems in the service supported this practice.
Care planning systems were satisfactory. Care plans outlined people’s needs and were reviewed when people’s needs changed.
People received support from external health professionals and were encouraged to live healthier lives.
People said they received support from staff which was caring and respectful. Care promoted people’s dignity and independence. People were involved in decisions about their care.
People felt confident raising any concerns or complaints. The service had an effective complaints procedure.
Staff induction procedures were satisfactory. Staff received suitable training to carry out their roles. Suitable records were available to demonstrate staff received regular one to one supervision with a senior member of staff.
The team worked well together and had the shared goal of providing a good service to people who used the service.
The service was managed effectively. People, relatives and staff had confidence in the management of the service.
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 30 September 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
We carried out this announced inspection on 6 and 7 September 2017. We announced this inspection in line with our methodology for inspecting domiciliary care services. At the last inspection, in August 2015, the service was rated Good. At this inspection we found the service remained Good.
People, and their relatives, told us they were happy with the care they received and believed it was a safe service. People and their relatives commented, “Quite satisfied”, “Brilliant service” and “I have not had any problems since using the service.”
People had a team of regular, reliable staff, they had agreed the times of their visits and were kept informed of any changes. No one reported ever having had any missed visits. People told us, “Always turn up on time, if not they ring me to let me know” and “They always come.”
Staff treated people respectfully and asked people how they wanted their care and support to be provided. People and their relatives spoke positively about staff, commenting, “They are very kind to me”, “I can have a laugh with them”, “Staff don’t rush me”, “They all make me feel very comfortable” and “They are extremely kind and considerate.”
Staff were knowledgeable about the people they cared for and knew how to recognise if people’s needs changed. Staff were aware of people’s preferences and interests, as well as their health and support needs, which enabled them to provide a personalised service. People who needed help taking their medicines were appropriately supported by staff.
People had a care plan that provided staff with direction and guidance about how to meet people’s individual needs and wishes. These care plans were regularly reviewed and any changes in people’s needs were communicated to staff. There was an effective system in place for staff to feedback any changes to people’s needs. Assessments were carried out to identify any risks to the person using the service and to the staff supporting them. This included any environmental risks in people’s homes and any risks in relation to the care and support needs of the person.
Staff were recruited safely, which meant they were suitable to work with vulnerable people. Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any allegations made would be fully investigated to help ensure people were protected.
Management provided staff with appropriate training and supervision. There were sufficient numbers of suitably qualified staff available to meet the needs of people who used the service. Rotas were well managed and the registered manager knew the location and times where new packages could be accepted.
The service acted within the legal framework of the Mental Capacity Act 2005(MCA). Management and staff understood how to ensure people who did not have the mental capacity to make decisions for themselves had their legal rights protected.
There was a positive culture within the staff team and staff spoke passionately about their work. Staff were complimentary about the management team and how they were supported to carry out their work. The registered manager was clearly committed to providing a good service for people. Comments from staff included, “I would not work for anyone else”, “They [management] really value us”, “They are a good company to work for” and “[Registered manager] talks to us every week when we pick up our rotas. She makes sure you are OK and not too stressed.”
There were effective quality assurance systems in place to help ensure any areas for improvement were identified and action taken to continuously improve the quality of the service provided. People told us they were regularly asked for their views about the quality of the service they received.
People had details of how to raise a complaint and told us they would be happy to make a complaint if they needed to.
Averlea Domiciliary Care is a community service that provides care and support to adults of all ages, in their own homes. The service provides help with people’s personal care needs in St Austell and surrounding areas. This includes people with physical disabilities and dementia care needs. The service mainly provides personal care for people in short visits at key times of the day to help people get up in the morning, go to bed at night and support with meals.
At the time of our inspection 29 people were receiving a personal care service. These services were funded either privately or through Cornwall Council.
There was a registered manager in post who was responsible for the day-to-day running of the service. 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 and associated Regulations about how the service is run.
We carried out this announced inspection on 7 and 10 August 2015. We told the provider five days before that we would be coming. This was to ensure the registered manager and key staff were available when we visited the agency’s office. It also meant we could arrange to visit some people in their own homes to hear about their experiences of the service. The service was last inspected in September 2013 and was found to be meeting the regulations.
People we spoke with told us they felt safe using the service and told us, “The service is fantastic”, “No complaints, quite happy” and “I won’t change to anyone else”.
Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any allegations made would be fully investigated to help ensure people were protected. There were sufficient numbers of suitably qualified staff to meet the needs of people who used the service.
People were supported to take their medicines by staff who had been appropriately trained. People received care from staff who knew them well, and had the knowledge and skills to meet their needs. People told us staff always treated them respectfully and asked them how they wanted their care and support to be provided. People and their relatives spoke well of staff, comments included, “They [staff] are a good set of girls”, “We are happy with the care”, “They [staff] get on well with my husband” and “Staff have a good understanding of mum’s needs”.
Care plans provided staff with clear direction and guidance about how to meet people’s individual needs and wishes. The service was flexible and responded to people’s needs. People told us about how well the service responded if they needed additional help. For example providing extra visits if people were unwell and needed more support, or responding in an emergency situation. People told us, “They [the service] have changed the times of visits to fit around us” and “The service changes times of my visits to fit in with when I need to go out”.
The management had a clear understanding of the Mental Capacity Act 2005 and how to make sure people who did not have the mental capacity to make decisions for themselves had their legal rights protected.
There was a positive culture in the service, the management team provided strong leadership and led by example. Staff told us, “Best company I have worked for” , “Good support” and “If I had any problems I would go to the manager or supervisor and I know they would listen”.
There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed.
We saw people's privacy and dignity were being maintained. People we spoke with told us 'They treat me kindly and with respect' and 'I have never been spoken to in a patronising way'.
We saw care plans were detailed and gave direction as to the care and support people needed. They had been regularly reviewed. Comments for people who used the service we spoke with included 'I couldn't fault the company' and 'they always ask if I need anything else; they are lovely'.
We were told people felt safe when care workers were in their home. We saw the information care workers were given about safeguarding adults.
The agency had systems in place to monitor the quality of the service provided.
People told us that they felt able to express their views directly to the carers or could telephone the office and speak to the registered manager if they needed to. They told us they felt involved with the service they received.
Everybody we spoke with said they felt safe when receiving care from the Averlea domiciliary care staff.
Staff were not provided with up to date policies and procedures that were easily accessible to them. For example, the safeguarding policies and procedures had not been updated to reflect the local multi-agency procedures in place in Cornwall. A recent safeguarding issue had not been reported following the correct process, although the agency had taken action to protect the person who used the service.
A programme of staff training and supervision was in place to ensure that the staff were competent and trained to deliver the required care to people who used the service.
During our first visit to Averlea we spoke with the registered manager of the domiciliary care agency but she was not available for the rest of the inspection. We spoke with the registered manager of the care home and one of the owners during all of the visits to Averlea.
At the time of this review the domiciliary care agency provided services to approximately 75 people, most of whom received personal care, and employed approximately 30 staff. There were 13 people living in the care home and 10 care staff were employed as well as domestic and catering staff.
During our visits to the office we looked at records pertaining to both the domiciliary care agency and the care home. These included records relating to the care and support people received, staff files, the operation of the care home, and policies and procedures. We asked for the staff training records, and some other documentation, to be sent to us which we received on 19 March 2012. We also asked for the quality assurance records but were told by the registered manager of the care home that there was no system in place to assess and monitor the quality of care provided or to identify, assess and manage risks relating to the health, welfare and safety of people who use the service and others who may be at risk.
People who received care and support from the domiciliary care agency were very positive about the way they were treated by the staff who supported them. Comments from people receiving the service and their relatives included "them's lovely", "we think the world of them", "we can't praise them enough" and "they respect me as a person". People also said that the agency was reliable, flexible around people's changing needs, and time keeping was "very good". However the agency did not have robust arrangements in place to safeguard people against the risk of abuse as few of the staff had received training in this area and the agency's policies and procedures were not clear about the action staff should take.
People who lived in Averlea Residential Home said they were happy living in the home, felt safe and were well cared for. Comments included "we are so well looked after", the staff were "lovely" and "they treat me like one of the family". We observed interactions between the staff and people who lived in the home and saw that staff were friendly and respectful to the people they supported. People talked to us about their personal routines, the activities they enjoyed, and the meals provided in the home. People said they were involved and supported to make decisions about their personal and healthcare needs and that these were being well met by the staff team and visiting healthcare professionals. People received their medicines when they needed them and these were administered in a safe way. However we found that there was no protocol for the administration of 'as required' medicines and medicines were not always being stored or disposed of properly.
People also told us they had not been provided with any information about the home, they did not know how to make a complaint, they did not know who the registered manager was or her name, they were unaware of their care plans and had not been involved in writing them, no activities took place apart from bingo and they were never told what the next meal would be. They said there were no meetings held between the people who lived in the home and the management, they had never been consulted about the quality of care in the home, and had no involvement in how the home was run. We also found that the arrangements in the home to safeguard people from abuse, such as written policies and procedures, were not suitable which may place people at risk of abuse.
During our visit to the office we examined the care files belonging to five people who received a domiciliary care service and four people who lived in the care home. We found that the care and support plans for both people receiving domiciliary care and living in the care home contained detailed information about some aspects of people's care and gave clear directions to staff about how people wanted each task to be carried out. However, from discussion with the people who used the services, we found that the care plans did not contain all of their care and support needs; the people receiving a domiciliary care service said the staff did not always read them; and the people living in Averlea Residential Home were not aware of the existence of the care plans. We also looked at the financial records of three people who lived in the home whose spending money was administered by staff in the home. We found that these records were not audited on a regular basis to ensure accuracy and protect people from possible financial abuse.
During our visits to the care home we looked around the communal parts of the care home and eight bedrooms. We found that all the bedrooms were warm and most of them contained many personal possessions, although this varied from one person to another. The bedroom doors had locks fitted but, if locked from the inside, the staff were not able to enter in an emergency. None of the bathroom and toilet doors available to the people who lived in the home had locks fitted which meant that people's right to privacy was compromised.
During our first visit we found that none of the bedroom doors had 'hold open' devices fitted that would automatically close if the fire alarm went off but these had been fitted by the time of our second visit. After discussions with staff about what to do in the event of a fire, and the registered manager saying that the fire risk assessment needed updating and that she had not yet written the personal evacuation plans for each person living in the home, we made a referral to the fire service due to our concerns regarding fire safety awareness in the home.
We looked at staff training records and spoke with staff from the domiciliary care agency and the care home about the training they had received to enable them to do their jobs. We found that almost all of the staff had qualifications in care and had received some training related to essential areas of their work. However we also found that staff had not received training related specifically to the needs of the people they supported to enable them to deliver care and treatment to people safely and to an appropriate standard.