Archived: Agincare UK Southampton

Updated 11 September 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

Our inspection was completed by one inspector and an expert 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. We started our inspection activity on the 25 July 2019 and completed this on the 2 August 2019.

Service and service type:

This service is a domiciliary care agency. It provides personal care, respite and domestic

services to people in their own homes, some of whom will be living with dementia or have complex health needs. The service operates mainly in the Hythe and Totton areas of Southampton.

There was no registered manager in post during our inspection. A registered manager is a person who has registered with the Care Quality Commission. 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. The previous registered manager had left the service in May 2019. A new manager had been recruited and had started at the service two weeks prior to our inspection.

Notice of inspection:

We gave the service 48 hours’ notice of the inspection visit because we needed to be sure that relevant staff would be available to facilitate the inspection.

What we did:

We visited the office where we spoke with the manager, area manager, field care supervisor and five care staff. We contacted 22 people and 15 relatives by telephone and asked them about their experiences of using the service. We viewed the care and support records for five people and other records relating to the management of the service such as audits, training and recruitment records and policies.

Before the inspection, we reviewed all the information we held about the service. We had not asked the provider to complete a provider information return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also spoke with the local authority to seek feedback about the service.

Updated 11 September 2019

About the service: Agincare UK Southampton is a domiciliary care agency that provides personal care, respite and domestic services to people in their own homes some of whom were living with dementia and complex health needs. Not everyone using the service received a regulated activity. The Care Quality Commission (CQC) only inspects the service being received by people provided with 'personal care', that is, help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of our inspection, there were 40 people receiving a personal care service.

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

People consistently raised concerns about calls being later than planned. They also told us that continuity of care needed to improve. Risk assessments did not always fully reflect people's needs or take account of all risks to their health and wellbeing. Medicines administration records did not always provide assurances that people were receiving their medicines as prescribed or in line with best practice frameworks. Systems and processes were in place to safeguard people from the risk of abuse. Good practice guidance was followed to ensure infection prevention and control processes were implemented. When things went wrong such as late calls or missed visits, reviews and investigations were not always undertaken to support lessons being learnt.

The systems in place had not been fully effective at improving the quality and safety of the service. The previous registered manager, deputy manager and all members of the office team had recently left their roles. A new manager had been appointed but had only been in post two weeks when we inspected. Staff were positive about the new manager and felt she had already had a positive impact on the service. They were hopeful the new manager would drive the required improvements.

Overall people were supported in the least restrictive way possible and there was evidence that capacity to consent to their care and support was considered as part of the care planning process, however, this had not always been well documented. Some people felt that their care workers needed to be better trained. The records provided to us relating to staff training were incomplete and so we could not be assured about this. People were supported with their health and nutritional needs.

People were also not kept adequately informed about any changes to their support. This limited their ability to have choice and control over their care. People told us the confidentiality of information was not maintained. Staff were kind and caring and some people had been able to develop positive relationships with their care workers which they valued.

Care plans contained personalised information about people’s preferences, likes and dislikes and life histories. Where people had regular care workers, staff were knowledgeable about their needs and this helped to ensure that they received personalised care. A complaints policy was in place and information about how to complain was in the Care Services Guide. People were generally confident that their complaints had been listened to and acted upon.

Rating at last inspection

The last rating for this service was requires improvement (published 8 November 2018) and there were two breaches of the Regulations. At this inspection we found improvements had not been made /or sustained and the provider remained in breach of one Regulation and two new breaches were found.

The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.

Why we inspected

The inspection was prompted in part due to concerns received about whether there were enough staff to ensure people received a reliable and consistent service. A decision was made for us to inspect and examine those risks.

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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk