Archived: Agincare UK Eastbourne

This inspection took place between the 18 and 25 May 2017. We visited the office of Agincare UK – Eastbourne on the 18 and 19 May 2017. We told the provider we were coming on the two days we visited the office this was due to it being a domiciliary care agency and we needed to ensure someone was available. The inspection involved a visit to the agency’s office and telephone conversations with people, their relatives and staff, between the beginning and end dates.

Agincare UK Eastbourne is a domiciliary care company based in Eastbourne. They provide support and care for predominately older people living in their own homes. Some people were at risk of falls and had long term healthcare needs. Agincare UK - Eastbourne provide their services within an approximate 10 mile radius from their office in Eastbourne. At the time of our inspection 55 people were using the service. There was a registered manager in post, a registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People and their relatives spoke positively about the service provided and the leadership at Agincare UK – Eastbourne. However we found some aspects of the service were not always well led. There had been some shortfalls in the communication of operational and administrative information which had impacted on the effectiveness of the registered manager. The software used to track and schedule care calls did not consistently allow senior staff to have clear auditable oversight of some areas of the operation.

People told us they felt safe using the services of Agincare UK - Eastbourne. Comments included, “I have been very pleased with the care we’ve had, never had any worries.” Staff had an understanding of safeguarding people from different types of abuse and how to raise and escalate any concerns they had for people’s wellbeing and safety. Where people had been involved in an incident or accident steps had been taken to investigate and follow up to reduce the risk of them being repeated.

Medicines were managed safely and in accordance with current regulations and guidance. Medicines records were audited and reviewed to check for errors or omissions. Staff knowledge and competency was routinely assessed to ensure they were confident to support people with their medicines.

Risks and support needs associated with caring for people in their own homes had been assessed and were reviewed appropriately. Care plans were person centred and details recorded were consistent. Staff supported people to access health care services if required. Staff told us they knew people well and recognised if they were unwell.

Staff had an understanding of the requirements of the Mental Capacity Act 2005 (MCA). Care documentation reflected action had been taken and appropriate agencies involved where appropriate.

There were enough staff to meet people's support needs and staff had regular training, supervision and appraisal to support them in their roles. Staff gave positive feedback about the training they underwent and people said staff were well trained. Appropriate pre-employment checks had been completed before staff began working for the provider.

People knew how to make a complaint or raise concerns with staff or the registered manager. There was an appropriate complaints system in place. People told us they were supported by friendly, reliable and caring staff who respected their privacy and promoted their independence. People who needed it were supported to eat and drink enough and staff knew what to do if they thought someone was at risk of not eating or drinking sufficient amounts. People were supported with their day to day health care needs.

A range of quality assurance systems had been established; these were completed to ensure people received safe and good quality care and checked areas such as medicines and care documentation. Additional audits were completed by one of the provider’s regional managers.

Agincare UK Eastbourne is a domiciliary care company based in Eastbourne. They provide support and care for predominately older people living in their own homes. The age range of people was receiving support was between 50 to 95 years of age. Some people were at risk of falls and had long term healthcare needs. Agincare UK Eastbourne provide their services within an approximate 10 mile radius from their office in Eastbourne. At the time of our inspection 80 people were using the service. There was a registered manager in post, a registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

We last inspected Agincare-Eastbourne on 13 February 2014 where we found they were compliant with the regulations inspected.

People spoke positively about the services they received from Agincare – Eastbourne and told us they felt safe using their services. However we found there were inconsistencies in regard to how the provider managed the administration of medicines. All staff had an understanding of safeguarding and different types of abuse, however not all staff knew the procedure for reporting abuse beyond the provider.

When people started using the service they underwent a pre-assessment which identified their care and support needs. Risk assessment was completed for areas where people could be at risk of harm, such as with their walking and the environment. People’s support needs were generally, unless an issue was identified by staff, reviewed on an annual basis. We found there was a reliance on care staff to identify changes to people’s risk level and care needs within this intervening time period rather than the provider. This increased the risk changes in people’s support needs could be missed or overlooked.

People told us they were usually supported by staff who knew them well and had the appropriate level of experience and knowledge to meet their needs. However care documentation did not consistently reflect the care delivery that was being provided. Care plans were focused on a specific task list which care staff were to complete and did not always provide detail on how the individual could be best supported for each identified need.

Although the feedback received on the provider was positive we found they did not have robust quality assurance systems in place which were capable of identifying the areas of improvement we found during the inspection. For example in relation to people’s care and medicine documentation. We found additional areas which required improvement were related to the leadership of Agincare - Eastbourne such as the submission of statutory notifications to the Care Quality Commission.

Care staff told us they felt supported in their roles. A supervision programme was in place which was used to support them in their roles. People were cared for, or supported by, sufficient numbers of experienced staff. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work for Agincare - Eastbourne.

Care staff had an understanding of the requirements of the Mental Capacity Act 2005 (MCA) and care documentation reflected action had been taken and appropriate agencies involved where necessary.

People told us they felt their care needs were met by friendly, reliable and caring staff. People had been involved in their care and were clear how to raise concerns if they had any. The feedback we received about the service was positive. There was a philosophy of care at the service which was familiar to and understood by staff. This included the importance of people’s independence.

We found 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.

During our inspection we looked at care documentation. We saw that people had been involved in decisions about their care, and had signed to confirm they had read and consented to care decisions.

We spoke with people who used the service. One person told us 'I could not be more satisfied, staff really could not be any nicer.'

Care needs had been reviewed and updated regularly if changes occurred. Staff had attended safeguarding training, and displayed knowledge of how to recognise and report concerns.

Staff records showed that appropriate checks had taken place before people commenced employment, and the provider had systems in place to assess and monitor the quality of the service provided.

We looked at the complaints policy and records and found that complaints were dealt with in an open and effective manner.

We spoke with three members of staff who told us they enjoyed their job. One care worker told us, 'I am very happy here, I work with lovely colleagues and the people I work for are lovely too.'

We found that people were given choices and their preferences were respected. People told us they were treated with privacy and dignity. We found that staff were aware of ways to protect and keep people safe from abuse. There were policies in place and staff understood their responsibilities to report any concerns. There were effective arrangements in place to involve other services and healthcare professionals. This ensured that people were kept safe and their changing needs responded to.

We found that training for staff had been monitored and training sessions planned that ensured staff kept their skills and knowledge up to date. Staff were supported through observation, supervision and appraisal.

The agency had assurance systems in place to monitor the quality of the service provided and to gain the views of people. There was a system for responding, recording, monitoring and improving the service from the complaints process.