We carried out a review of the data available to us about Agincare UK Bristol 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 UK Bristol, you can give feedback on this service.
Agincare UK Bristol is a domiciliary care agency providing care and support to people living in their
own homes in Bristol and South Gloucestershire. At the time of our inspection 141 people were using the service.
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
People spoke highly of the care and support they received from care and office staff. Visits were completed at the time agreed and for the full amount of time. Care was person centred and people were asked how they wanted to be supported. Staff knew people well and ensured their care needs were met.
Staff knew how to keep people safe and free from avoidable harm. Risk assessments were in place. Staff knew what to report to the office to ensure people were safe. Policies and procedures were in place to guide staff on keeping people safe and the reporting of allegations of abuse.
The registered manager and staff had a good understanding of supporting people safely during the current pandemic. Staff felt supported and valued. There had been sufficient personal protective equipment, staff training and regular updates throughout. Regular COVID-19 testing was in place for all staff weekly and results were passed to the management team. People confirmed they felt safe during this period of time.
Staff were recruited safely. New staff were supported in their role and shadowed more experienced staff.
People, relatives and staff spoke positively about how the service was managed. There were robust systems in place to monitor the quality of the service including seeking feedback from people using the service and staff.
Rating at last inspection
The last rating for this service was good (published June 2018).
Why we inspected
We received concerns in relation to the management of staff absence. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. We found no evidence during this inspection that people were at risk of harm from this concern.
The overall rating for the service remained the same good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Agincare UK Bristol on our website at www.cqc.org.uk.
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.
At the time of the inspection 85 people were receiving a personal care service from Agincare UK Bristol. This service is a domiciliary care agency. It provides personal care to people living in their own home. Not everyone using the service receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
There was a registered manager in post at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. 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.
Staff knew the signs of abuse and were confident to raise any concerns they had with the registered manager and provider. People told us they were confident to raise any concerns they had with staff and that any concerns they had raised had been acted on. People had individual risk assessments so that staff had the information they needed to support them safely and minimise the identified risks.
People's medicines were now being managed safely. Medicine administration records were fully completed and signed by staff. Changes in people's health were identified quickly and staff supported people and their relatives to contact their health care professionals.
There were sufficient staff to meet people's needs. People told us staff generally arrived on time however some people had experienced late calls. The registered manager had already identified this as an issue and had tightened the areas that staff worked within to avoid this from happening. The staff told us they now had sufficient time between care visits.
The service carried out pre-employment checks on staff before they worked with people to assess their suitability. Staff were provided with sufficient personal protective equipment to prevent risk of spread of infection.
Spot checks were carried out to monitor staff performance. Staff attended regular training to ensure they could meet people's needs. There was a thorough induction to the service and staff felt confident to meet people's needs before they worked independently.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff understood the importance of gaining consent from people and acted in accordance with the principles of the Mental Capacity Act 2005. Staff assumed people had capacity and respected the decisions they made.
Staff provided care in a way that respected people’s dignity, privacy and independence. People told us staff treated them as individuals and delivered personalised care.
People's care plans were personalised and gave information on their background history, likes and dislikes. Staff were trained in person-centred care and knew how people liked to be supported. Care records were reviewed with people and they had been provided with sufficient information about the service. People and their relatives knew how to make a complaint.
The registered manager assessed and monitored the quality of the service. These included regular audits and ways to seek people's views about the service provided. People the management team and staff were approachable and willing to listen.
We undertook an announced inspection on 21 February 2017 to check the provider had made improvements and to confirm that they had done what they told us they would do in the action plan sent to us. At this inspection we found improvements had been made in relation to safe management of medicines. However, improvements were still required in relation to aspects of medicines management and assessing and monitoring the quality of service that people received.
We told the provider 48 hours before our visit that we would be coming. We did this because they were sometimes out of the office supporting staff or visiting people who use the service. We needed to be sure that they would be available.
Agincare UK (Bristol) is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community . It provides a service to older adults. At the time of our inspection 115 people were receiving personal care. Some people who used the service required support to maintain this independence. Other people required more support due to their long term healthcare needs such as diabetes and Parkinson’s disease or the risk of falls. Some people were living with dementia type illnesses.
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.
At this inspection we found medicines were managed safely and there was clear guidance about how staff should apply topical creams to people who required them. However, the medicines administration record charts were not completed correctly. This put the people who used the service at risk.
There were systems to assess the quality of the service provided. However the registered manager had not identified the shortfalls we found.
Care plans contained information which reflect people’s current support needs and included the level of detail staff required to provide people with their level of support.
People told us staff were helpful, caring and polite and supported them in the way they chose. Staff knew people well as individuals and had a good understanding of people’s care and support needs. There was information about people’s mental capacity in their care plans and we found when people lacked capacity it was clear how consent was sought or how decisions were made in their best interest.
There were enough staff and recruitment practices were followed to employ staff to look after people who used the service. The registered manager undertook an assessment before people started using the service to ensure there were enough staff to support them appropriately.
Staff had received regular supervision or spot checks to ensure they were supporting people properly
When required people received support from staff to have enough to eat and drink and maintain a healthy diet. This was recorded in their care plans and staff had a good understanding of the support people needed.
People told us the registered manager was approachable and they were able to discuss any concerns or issues with them.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report
This inspection took place on 21 January 2016 and was announced. We gave the service 48 hours’ notice of our intention to undertake an inspection. This was because the organisation provides a domiciliary care service to people in their own homes and we needed to be sure that someone would be available at the office.
At the last inspection of the service on 8 May 2013 we found the service was meeting the regulations we looked at.
Agincare (UK) Bristol provide support to people who live in the community. The range of support includes assistance with personal care, shopping, activities and appointments. At the time of our inspection Agincare (UK) Bristol provided services to 102 people.
There was a registered manager for the service. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated regulations about how the service is run.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we asked the provider to take at the back of the full version of this report.
People’s medicines were not always managed safely although they were administered to people as prescribed. There were processes in place to help make sure people were protected from the risk of abuse. Staff were aware of safeguarding vulnerable adults procedures. However, the provider’s policy in relation to managing people’s finances was not being followed accurately.
People who used the service said they were safe. The staff team were well trained and had good support from the registered manager and senior staff. They were confident in reporting any concerns about a person’s safety and were competent to deliver the care and support people needed.
Assessments were undertaken of risks to people who used the service and staff. Written plans were in place to manage these risks. However for one person an assessment had not been updated following alterations at their home.
The management team used a variety of methods to assess and monitor the quality of the service. These included satisfaction surveys and care reviews. Overall satisfaction with the service was found to be positive. However, some audits had not identified shortfalls to ensure lessons could be learnt to improve the service.
The people we spoke with expressed positive views about the service and spoke highly of staff and the registered manager. People were consulted about their care, needs and wishes. Where people lacked the capacity to consent, policies and procedures were in place in line with the Mental Capacity Act 2005 (MCA). Staff had an understanding of the requirements of the MCA and had received training on the subject.
Staff knew the people they were supporting and provided a personalised service. Care plans were in place detailing how people wished to be supported. People were involved in making decisions about their care. People told us they liked the staff and looked forward to the staff coming to their homes.
When meeting with people in their own homes we saw staff treating people with respect and providing assistance in a kind and caring manner. It was evident that people and staff members had cordial and friendly relationships.
Care records provided information to direct staff to deliver people’s care and support safely. Records had been kept under review so information reflected the current and changing needs of people.
Staff had a good understanding of people’s daily care needs and, where necessary, ensured that people who used the service had access to community health care and support. Health and social care professionals we spoke with gave positive feedback about the service and felt staff were professional and cooperative.
We conducted telephone interviews with a further four members of staff, seven people who use the service and two relatives on the 9 and 10 May 2013. This was to enable us to make a judgement about the care that was being provided to people receiving a service from Agincare.
People told us they had a care plan and that they had been involved in making decisions about how they wanted to be supported. People confirmed they were happy with the service and this had improved over the last twelve months.
One person told us 'I am happy with the service that I get from Agincare, the girls are lovely, cannot fault them'. Another person said 'the service has improved over the last twelve months I am now having regular staff and usually they arrive on time if not they will ring'.
People can be assured staff received training and support to enable them to fulfil their role. Systems were in place to ensure suitable staff were recruited to support them.
People were asked for their views in respect of the service they were receiving.
The provider had an effective system to regularly assess and monitor the quality of service that people receive. The newly appointed manager had developed an action plan to further improve the running of the business including staff training and supervision.
The agency has now met both the warning notices that were served in January 2012 as evidenced in previous reports about the service and during this visit.
People told us they were happy with the care and support they were receiving from the care staff and the improvements that had been made to the running of the office.
We were told that care staff and the timings of visits were more consistent. People told us they were sent a weekly letter detailing the times of the calls and the names of the staff that were to attend to them. These were being monitored.
People's views about the service were being sought and acted upon.
In April 2012 we carried out a review to check that the provider had carried out improvements in care and welfare for which we issued a warning notice. The provider was still non-compliant with this essential standard.
In the review we carried out in April 2012 people told us the service had improved and they had more confidence in the agency.
People told us at the review in April 2012 that they were happy with the service provided by individual care staff and that the care they received was of good quality.
At the review in April 2012 one person told us, 'It's new ones (staff) all the time. They are all very good. I have no complaints at all'. Another person told us that they had a regular carer who was, 'a brilliant chap'.
All the people we spoke to told us that visits had been missed and that care staff were often late. People were anxious not only about what time care staff would arrive but worried that they would not turn up at all.
People had complained to the office staff but nothing had changed. People told us that they were unhappy about not having regular care staff although they told us that most staff provided very good care.
People told us that a lot of staff had left recently.
People told us they were happy with the care they were receiving although they had concerns about how it was managed in respect of timekeeping and knowing who was supporting them each day.
All confirmed they had a copy of their care plan and where able the individual or their representative had signed the plan of care. People told us the staff treated them in a respectful manner.
People told us they had a care plan file containing information about Agincare and their care needs. They said that the carers always looked at the care plans every day and recorded the care they had been given in their daily notes. This was confirmed in records we saw in the office.
People said they were satisfied that the level of detail in their care plan was good and it explained exactly how they wanted to be assisted. People told us that the carers always check with them what they wanted doing and where care was refused this was respected.
People did tell us they knew how to complain and raise concerns with the agency.
People we spoke told us they were satisfied with the carers that were supporting them. We were told staff were courteous, polite and treated them with respect.
People told us they were happy with the carers that were supporting them and that they had the skills to enable them to do their work.
However, they told us they had concerns about the organisation of the agency in relation to the office management including timekeeping of the attendance of care staff, keeping them informed about late calls and letting them know who was going to be supporting them on a daily basis. Some of the people we spoke to said they had raised complaint about timekeeping, the amount of carers that were supporting them and in some cases missed calls and missed medication administration.
People told us they felt that the agency had listened to their concerns and they had made a number of improvements. They told us that the agency has asked them for their views on the quality of the service in various ways, including telephone calls, surveys and visits from a member of the management team to review the service and 'spot checks'.
We saw evidence to show the agency had various methods in place to gather information about the quality of the service. Agincare have carried out a national quality monitoring programme. The manager told us that surveys were sent out by the main office of Agincare and then these were then sent to the branch. We reviewed the results of the latest survey. There was no date on the survey but the manager told us that they had been completed in August 2011. Whilst in the main people were satisfied with the care they were receiving they were concerned about the administration provided by the office for example late or missed calls and the amount of carers that they were having to support them. This was similar to the feedback that we received on the telephone from people who use the service or their relatives. We asked how the results of the surveys were collated, and the action they had taken to address the areas where they needed to improve. While we were satisfied that they read all the responses there was no evidence to show how they collated the results and told people what they planned to do to make improvements where necessary.
The agency was not reporting and sharing information with us. This means that we are unable to act swiftly to ensure ongoing compliance and check that suitable action has been taken by the Agency in protecting people who use the service.