Archived: Lady Anne Care Agency

Updated 21 December 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 21 September 2016 and was announced. The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to be sure people receiving a service, staff and the manager would be available to speak to us. One adult social care inspector undertook the inspection.

Before the inspection we reviewed the information we held about the service. This included previous contact about the service and notifications we had received. A notification is information about important events which the service is required to send us by law. The provider also completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We used a range of different methods to help us understand people's experience. We spoke with two relatives over the telephone and visited one person in their own home. We spoke with three care staff, an administrative member of staff, and the manager.

We looked at three care plans including risk assessments and records relating to medicines. We looked at three staff files including recruitment information and training. We checked how the provider handled complaints and assessed and monitored the quality of the service.

Updated 21 December 2016

Lady Anne Care Agency provides live-in care and support to older people, who live in their own homes, in the area of Devon. At the time of this announced inspection, nine people were receiving personal care from the service.

The service had a registered manager. They were planning to retire and were not available at the time of our inspection. The registered manager visited the service once a week. They were on call at all times. 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. There was a new manager in post who had worked at the service for around three months. They planned to register as manager. They are referred to as ‘the manager’ throughout the report.

The service met all of our regulations at the previous inspection in July 2013. We visited the office and carried out a home visit and telephone calls to people and their relatives on 21 September 2016

People told us staff knew how to meet their needs. Comments included "They do a good job” and “They seem to be trained and understand (name’s) needs”. Some staff were completing diplomas in health and social care. However, not all staff had received up to date training to ensure they could meet people’s needs effectively. Some staff had not received training in moving and handling, medicines, first aid, health and safety, safeguarding, MCA and infection control.

Some care plans were out of date and didn’t reflect people’s current needs. People had a care plan in their home with details of the care and support services they were receiving. Some of these plans were brief or basic and did not include significant detail, but people told us that the staff knew what they needed and how they liked it done. Systems in place had not identified this, over a long period of time.

People who used this agency benefitted from staff who knew them well, and from a management team who were committed to providing a personal service. However, we found that systems for auditing practice had not been in place or were not robust enough. Since the manager had started work at the service, they had identified a number of shortfalls. They had written an action plan to address these.

People and their relatives were happy with the staff who supported them. Comments included "Very good indeed”; “They have been wonderful” and “Happy with staff”. Staff spoke about the people they cared for with compassion and concern. People told us staff were respectful and polite. We saw a staff member interact with one person in a friendly way, they knew each other well and the staff member chatted with them with warmth. People were supported with their health and dietary needs, and told us that staff would prepare meals of their choice. One person commented that their live in care staff was a good cook.

People and their relatives told us they felt safe and comfortable when staff were in their home and when they received care. People told us "I feel safe" and "There’s nothing to worry about". Staff knew how to recognise signs of potential abuse and understood how to report any concerns. Safe staff recruitment procedures were in place. This helped identify and reduce risks in the employment process.

Risks to the health, safety or well-being of people who used the service were assessed and reduced where possible. Where incidents had occurred, appropriate action had been taken and an investigation had been carried out to prevent a reoccurrence.

People were supported safely with their medicines and told us they were happy with the support they received. Staff completed medication administration record (MAR) sheets after giving people their medicines. We saw these had been fully completed.

People and their relatives felt able to raise concerns or make a complaint. They were confident their concerns would be taken seriously. People told us they didn't have any complaints. Comments included "Nothing could be better” and “We would contact them if we did have any concerns”. One relative told us when there had been an issue in the past it had been dealt with promptly.

People told us the management were approachable and they were happy with the service. Comments included "I’m very happy with it” and “I can call the office if I need to”. Staff told us there was an open culture. Staff said "Really approachable” and “We talk on the phone”. When one staff member experienced a problem, their feedback was “(manager’s name) really listened to me and supported the issues”.

We found 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 this report.