Archived: Absolute Care Services (Bromley)

Updated 5 October 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 2 inspectors who visited the location on the first day and 2 Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The Expert by Experience’s made telephone calls to people and their relatives on the first day of the inspection.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a manager in post who was in the process of registering with the CQC to become the registered manager for the service.

Notice of inspection

We gave the service 48 hour notice of the inspection. This was because we needed to be sure that the provider or manager would be in the office to support the inspection.

Inspection activity started on 4 July 2023 and ended on 12 July 2023. We visited the office location on the first day of the inspection.

What we did before the inspection

We reviewed the information we held about the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We also gathered feedback from the local authority. We used all this information to plan our inspection.

During the inspection

We visited the office and spoke with the manager, 2 directors, quality supervisor, compliance officer, rota coordinator, and 4 care staff. We spoke with 12 people using the service and 4 relatives of people using the service to seek their feedback on the service they received. We reviewed records, including 10 people’s care plans and risk assessments, 5 staff recruitment and training records and a variety of records relating to the management of the service, including quality monitoring systems and audits.

Updated 5 October 2023

About the service

Absolute Care Services (Bromley) is a domiciliary care service providing personal care support to people living within their own homes. People that could use the service included older people, people living with dementia, people with a physical disability, people with a learning disability or autistic spectrum disorder and younger adults and children. At the time of our inspection the service was providing care and support to 91 people.

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.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

Right Support: Model of Care and setting that maximises people’s choice, control and independence

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests. Risks to people were not always identified, assessed, fully documented, and mitigated to ensure people’s safety and well-being. Guidance for staff lacked detail with the actions they should take to safely mitigate and manage risks. Systems and processes in place for managing and administering people's medicines was not always safe.The provider was not working within the principles of the MCA. Mental capacity assessments were not completed in line with legal requirement, guidance, and best practice.

Right Care: Care is person-centred and promotes people’s dignity, privacy and human rights

People were not always central to the planning and reviewing of their care and assessments and care plans were not always person centred.

Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives.

The service was not always well managed. Systems and processes in place for monitoring the quality and safety of the service were not always effective in identifying and addressing issues and concerns we found at this inspection and for helping to drive service improvements.

We have made two recommendations to the provider. They need to refer to current law, best practice and up to date guidance in relation to ensuring people’s needs and choices are documented and delivered in line with good practice standards and when assessing and documenting people’s needs and wishes to ensure people receive personalised care and have choice and control.

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 April 2019). This was the provider’s first inspection since their registration at this new location.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Responsive and Well Led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Why we inspected

The Inspection was prompted in part due to concerns received about the quality and safety of care provided and the management and oversight of the service. A decision was made for us to inspect and examine those risks.

Enforcement and Recommendations

We have identified breaches in relation to the need for consent, safe care and treatment and good governance. We have also made two recommendations.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standard 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.