We carried out a review of the data available to us about Agincare Oxford 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 Agincare Oxford, you can give feedback on this service.
Agincare is a domiciliary care service providing the regulated activity of personal care. The service provides support to people living in their own homes. At the time of the inspection there were 46 people receiving the regulated activity of personal care.
The service also supports people who are discharged from hospital and require support with rehabilitation for an initial proposed period of six weeks. People receiving this rehabilitation care are referred to by the service as 'reablement care clients.' At the time of inspection 15 people out of 46 were receiving a reablement care package.
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
We received mostly positive feedback from people and relatives of those using the service. The service was meeting all requirements to ensure people had safe and effective care. Measures to manage any risks assessed were appropriately put in place.
People received medicines as prescribed, and staff knew how to maintain good infection control.
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.
People were supported to have a balanced diet and various professionals were regularly involved in people's care to ensure they received the right care and treatment. People received effective support from staff who were suitably trained and skilled.
People's care plans were personalised to reflect people's personal preferences and choices; however, some people felt their gender preference of care staff was not always sought. People knew how to complain, and complaints were investigated and responded to appropriately.
People were supported by staff who demonstrated they were kind and compassionate. Staff knew people's needs well. There was enough staff. The service used regular agency staff who enrolled in the services induction training and received spot checks. Staff felt supported by the service and spoke positively about management.
People had support from staff who responded to any changes in needs. Referrals to external healthcare professionals were made in a timely manner.
People's views were considered to improve the service. A number of methods were used to monitor the quality of the service people received. The management team had plans around continuous improvements and improving the standards.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
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.
At the time of the inspection, the location did not care or support anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.
Rating at last inspection and update
The last rating for this service was inadequate (published 25 October 2022) and there were breaches of regulations 9, 12, 13, 16, 17 18 and 20. We served a warning notice for Regulation 12 safe care and treatment. We followed up this warning notice on 5 January 2023 and found that they were no longer in breach of regulation 12. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
This service has been in Special Measures since 24 August 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection. We had carried out an announced comprehensive inspection of this service on 24 August 2022. Breaches of legal requirements had been found. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
We undertook this comprehensive inspection to check whether they had followed their action plan and to confirm they now met legal requirements.
The overall rating for the service has changed from inadequate to good based on the findings of this inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Agincare is a domiciliary care service providing the regulated activity of personal care. The service provides support to people living in their own homes. At the time of the inspection there were 36 people receiving the regulated activity of personal care.
The service also supports people who are discharged from hospital and require support with rehabilitation for an initial proposed period of six weeks. People receiving this rehabilitation care are referred to by the service as ‘reablement care clients.’
People's experience of using this service and what we found
This was a targeted inspection that followed up the Warning Notice served at the previous inspection around the safety of the service.
We use targeted inspections to follow up on Warning Notices or to check concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
The provider had worked closely with the local authority's quality team and had made improvements in relation to assessing risk, staff training, guidance and medicine management.
People's care plans had been reviewed in order to assess the risk associated to people's support needs, this included guidance the people required. Incidents and accidents were well documented and investigated, this enabled the correct action to be implemented to further mitigate risk.
Systems to ensure the safe management of medicines were now effective in ensuring good standards of care were delivered. People's medicines support needs had been adequately reviewed and updated since the last inspection.
Documentation to support the safe management of people’s skin integrity had now been included to peoples support plans and were being updated frequently.
Since the last inspection, the service had ensured; staff competencies were updated, further training was completed, and spot checks carried out in order to ensure safe practice and use of PPE.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was inadequate (published 25 October 2022).
At the last inspection we served a warning notices in respect of safe care and treatment. At this inspection we found improvements had been made, and the provider had met the warning notices in full.
Why we inspected
We undertook this targeted inspection to check whether the warning notices previously served in relation to Regulations 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. Therefore, the overall rating for the service has not changed following this targeted inspection and remains inadequate.
Enforcement
The provider remains in breach of regulations found at the last inspection. These relate to person centred care, safeguarding people from abuse, receiving and acting on complaints, good governance, duty of candour and staffing.
Special Measures
The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.
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.
You can read the report from our last comprehensive inspection, on our website at www.cqc.org.uk
The service also supports people who are discharged from hospital and require support with rehabilitation for an initial proposed period of six weeks. People receiving this rehabilitation care are referred to by the service as ‘reablement care clients’. At the time of inspection 15 people out of 53 were receiving a reablement care package.
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 provider did not operate effective quality assurance systems to oversee the service. These systems did not identify shortfalls in the quality and safety of the service or ensure that expected standards were met.
The provider did not ensure consistent actions were taken to reduce risks to people and plans were not in place to minimise those risks. The management of medicines was not always safe. Staff did not always follow correct infection prevention and control processes when carrying out personal care. Records indicated that not all staff had completed mandatory training. Following the inspection, we were informed by the managing director that staff receive a minimum of one supervision and team meeting a year as per their policy. We did not feel that staff received regular supervisions and team meetings.
When incidents or accidents occurred, it was not always clear these were investigated, and if any lessons were learnt. The provider did not follow and accurately record and keep a copy of incidents and the actions taken as required in the duty of candour regulation when a notifiable safety incident occurred.
The registered manager did not ensure clear and consistent records were kept for people who used the service and the service management and did not always inform us about notifiable incidents. Staffing levels did not always support people to stay safe and well.
People, their families and other people that mattered gave mixed feedback about being involved in the planning of their care. Care plans did not always contain information specific to people's needs or contain information on how to support people to manage any conditions they had. Staff were not provided with detailed guidance to follow when supporting people with complex needs.
The provider did not ensure their safeguarding systems were operated effectively to investigate and follow the provider's procedure after becoming aware of an allegation of abuse. Records indicated that not all staff were trained in this.
People and relatives gave good feedback about staff being kind, caring and respectful. The majority of staff members felt staffing levels were sufficient to do their job safely and effectively, we heard from people using the service that often staff were late and felt turnover was high.
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.
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.
At the time of the inspection, the location did not care or support anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 10 March 2022 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We looked at infection prevention and control measures under the Safe key question. We look at this in all inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Enforcement and Recommendations
We have identified six breaches in relation to quality assurance; risk management, safeguarding, record keeping, responding and acting upon complaints, effective and person-centred care planning, management of medicine and staff training and competence at this inspection.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.