17 December 2019
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.
The inspection was carried out by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older people, people with dementia, people with sensory impairment, People with physical and learning disabilities. At the time of our inspection the service was providing care and support to one person.
Notice of inspection
The inspection was unannounced.
What we did before the inspection
We reviewed the information we held about the service and the service provider. We looked at the notifications we had received for this service. Notifications are information about important events the service is required to send us by law. We also spoke with the local authority commissioners and other health and social care providers. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
During the inspection
We spoke with three people who used the service and one relative about their experience of the care provided. We spoke with four members of staff including the registered manager and three carers.
We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at three staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. In particular, we sought information on how the service was managing risk.
17 December 2019
About the service
Abel Care Ltd 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 people, people with dementia, people with sensory impairment, people with physical and learning disabilities. At the time of the inspection there were 26 people using the service.
People's experience of using this service and what we found
Risk assessments were not always personalised or updated regularly. Quality assurance measures were not always effective.
People had mixed views on staffing, though we found there were sufficient staff and robust recruitment measures in place. People held mixed views on whether medicines were managed safely, however, we found there were systems in place to ensure it was and staff were trained in, and competency assessed on medicine administration. They were adequate systems and processes in place to safeguard people from abuse. Staff understood infection prevention. Lessons were learnt when there were accidents and incidents.
The registered manager told us the service was in transition following an office move and were attempting to drive improvement at the service following our last inspection. They had made improvements to documentation since our last inspection. Staff told us they held meetings that were beneficial. We viewed compliments of the service and staff were spoken of positively. The registered manager understood their responsibilities and acted with candour when appropriate. There service worked with other agencies to the benefit of the people using the service.
Rating at last inspection and update:
The last rating for this service was requires improvement (published 06 August 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations.
You can see what action we have asked the provider to take at the end of this full report.
Why we inspected
We received concerns in relation to the management of the service. 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.
The overall rating for the service has remained the same. 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 Abel Care Ltd on our website at www.cqc.org.uk.
We have identified breaches in relation to managing risks and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.