Background to this inspection
Updated
14 November 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
This inspection was carried out by one inspector and one 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.
Service and service type
The service is a domiciliary care agency. It provides personal care to people living in their own houses or flats.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 5 October 2023 and ended on 11 October 2023. We visited the location's office on 5 October 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with 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 used all this information to plan our inspection.
During the inspection
We spoke with 6 people who use the service and 5 relatives of people who use the service. We also spoke with 4 staff, including the registered manager, the care coordinator and care workers. We reviewed a range of records. This included 5 people's care records and 3 staff records. A variety of records relating to the management of the service were also reviewed.
Following our visit to the service, we reviewed more records relating to the management of the service.
Updated
14 November 2023
About the service
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.
Accolade Care Services UK Limited is a domiciliary care agency providing personal care to people living in their own houses and flats. The service provides support to older people, people living with dementia, people with disabilities, people with mental health needs and people living with a learning disability and/or autism. At the time of our inspection there were 28 people 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
Right support
The provider had not always followed guidance for the administration of medicines and people's medicines had not always been managed safely. We found no evidence anyone had been harmed but this had put some people at risk of potential harm.
Accidents and incidents were reported and recorded. However, the provider had not regularly analysed and used the information to identify why things had gone wrong. This meant the process for learning lessons when things went wrong was less likely to be timely and therefore, less likely to be effective. During our inspection the provider said they would carry out accident and incident audits more regularly.
Infection prevention and control followed guidance and we were assured the provider was responding effectively to risks and signs of infection.
The service followed the Mental Capacity Act (MCA) and supported people to make decisions in accordance with the principles of the MCA.
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.
Right care
The provider had not always carried out risk assessments and put risk management plans in place for people and had not always updated people’s risk information. We found no evidence anyone had been harmed but this had put some people at risk of potential harm. People’s assessments and care plans were not always person-centred enough. However, there was a consistent staff team in place and staff knew people’s needs and preferences well and people received their care how they wanted it.
There were enough staff to meet people's needs and staff recruitment followed safer recruitment procedures.
People and their families said staff were caring, friendly and kind and respected their choices and privacy and dignity. Staff supported people to be as independent as possible.
There were systems and processes in place to safeguard people from the risk of abuse. Staff had received safeguarding training and knew how to recognise and report abuse and raise concerns. Safeguarding incidents and been reported appropriately and in a timely manner.
Right culture
There were quality assurance systems in place. However, not all the provider's audits were effective. The provider had not identified the issues we found.
Managers and staff were clear about their roles, they understood regulatory requirements and their duty to be open and honest with people when something went wrong.
There was a positive and supportive culture that was open, inclusive and empowering, which achieved good outcomes for people. The provider engaged and involved people, their relatives and staff in people's care and the development of the service. Managers provided staff with appropriate support. People, their families, staff and managers spoke positively about each other and feedback from people and their families about the service was very complimentary.
There were systems and processes in place to support continuous learning to improve the service. Staff worked in partnership with other organisations and services to provide people’s care and support.
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 21 February 2018).
Why we inspected
This inspection was prompted by a review of the information we held about this service. The overall rating for the service has changed to requires improvement based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Accolade Care Services UK Limited on our website at www.cqc.org.uk
Enforcement and Recommendations
We have identified breaches in relation to person-centred care, safe care and treatment and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
We have also recommended the provider familiarise themselves with the principles and requirements of the Accessible Information Standard.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.