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Archived: Arion Care Ltd

Overall: Requires improvement read more about inspection ratings

Damson Court, 87 Westley Road, Acocks Green, Birmingham, West Midlands, B27 7UQ (0121) 706 1618

Provided and run by:
Arion Care Ltd

All Inspections

14 June 2016

During a routine inspection

This inspection took place on 14 June 2016. We gave the registered provider notice of the inspection to make sure that the manager and the records we needed to look at were available on the day of the inspection. Arion Care Limited provides personal care to people living in their own homes. At the time of our inspection we were informed that they were providing a service to 37 people.

The service was last inspected in April 2015 when we found the service was not compliant with one of the regulations we looked at. The provider did not have suitable arrangements in place to monitor and improve the quality of the service. We issued a requirement notice and asked the provider to send us an action plan detailing the improvements they would make. An action plan was received. We revisited the service in June 2016 and found the regulation had not been met. In addition we identified other issues of concern related to safety issues.

We found that whilst there were some systems in place to monitor and improve the quality of the service provided, these were not always effective in ensuring the service was consistently well led and compliant with regulations. Audits and monitoring systems needed to be improved; these included the monitoring of recruitment practice.

There was not a registered manager in post at the time of our inspection. 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. One of the providers employees advised that they were managing the service on a day to day basis until a new manager was registered with CQC, they advised that they were the deputy manager. Staff and people using the service regarded this person as the manager and referred to them in this way. The new manager who had been employed was not available during the inspection.

Staff and relatives told us that people were safe. However, systems in place did not ensure that people would be protected from the risk of harm. The provider was not always following their own policies to ensure that safe recruitment processes were in place, and the lack of assessment of risk posed a risk to people who used the service.

Although people received their medication safely most of the time improvements were needed in the recording and monitoring of medication administration.

People could not be certain their rights in line with the Mental Capacity Act 2005 would be identified and upheld as issues of capacity and consent were not always fully understood by staff. Improvement was needed to ensure that staff had the training they needed, we saw induction of new staff was not fully completed. There was insufficient assessment of the competency of new staff to provide care effectively. Staff did not receive regular supervisions. We could not confirm that the service performed regular spot checks on all staff, to make sure they were working within safe practices.

People were fully involved in planning their care to ensure they could receive support in the way they wished. Peoples care was reviewed with them and care plans were altered accordingly if changes in care were requested. Most people we spoke with were happy with their care, and said that staff were kind and professional and respected their dignity and privacy. We saw that staff were reporting when they were concerned about people's welfare and that appropriate steps were taken in these cases. Care staff knew how to support people to ensure they received enough food and drink and when it would be necessary to approach other healthcare professionals for additional support.

There was a complaints procedure in place and people told us that they would not hesitate to contact the agency office if they had a concern. Improvement was needed to make sure the service learnt from people’s experience.

The service did not have effective systems to monitor and improve the quality of service people received. The system in place had failed to identify that the regulations had not been complied with. We received positive feedback from people and staff about the deputy manager but we found that arrangements for checking the safety and quality of the service by the registered provider were not effective. The leadership and management of the organisation had not ensured people would receive a service which safely met their needs.

We found breaches of Regulations with regards to staff recruitment, and good governance. You can see some of the action we told the provider to take at the back of the full version of this report. We are considering what further action we are going to take. Full information about CQC's regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

21 April 2015

During a routine inspection

This inspection took place on 21 April 2015. We gave the registered provider notice of the inspection to make sure that the manager was available on the day of the inspection.

Arion Care Limited provides personal care to people living in their own homes. At the time of our inspection we were informed that they were providing a service to 32 people. This was the first inspection carried out by the Care Quality Commission at this location.

There was a registered manager in post but they were on leave at the time of our inspection. 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.

Staff and relatives told us that people were safe. However, systems in place did not ensure that people would be protected from the risk of harm. Improvement was needed to make sure people received their medication safely.

We were told by people who used the service and staff, that people were supported at each call by the number of staff identified as necessary in their care plans. There were sufficient numbers of staff available to meet people’s individual needs but some people told us that the staff who supported them often changed and they had to get used to new staff.

The Mental Capacity Act 2005 (MCA) states what must be done to ensure that the rights of people who may lack mental capacity to make decisions are protected including when balancing autonomy and protection in relation to consent or refusal of care. We did not find anyone being deprived of their liberty but not all staff understood their obligations under the MCA and how it had an impact on their work.

Improvement was needed to the induction system for new staff to make sure they had the training and support needed to carry out their role effectively.

People who used the service told us that they were confident that care was provided in accordance with their needs. People described the staff as being kind and caring and staff spoke affectionately about the people they supported.

People told us that they had been included in planning and agreeing to the care provided. We saw that people had an individual plan, detailing the support they needed and how they wanted this to be provided. However we received mixed comments from people about the quality of the communication they received from the provider about how the company was performing and any changes to how their care would be delivered.

Care staff knew how to support people to ensure they received enough food and drink and when it would be necessary to approach other healthcare professionals for additional support.

There was a complaints procedure in place and people told us that they would not hesitate to contact the agency office if they had a concern. People were generally happy with the quality of the management. The senior management team was approachable however some relatives told us that they did not always respond effectively.

The service did not always have effective systems to monitor and improve the quality of service people received. Although people's views were sought, they were not always acted upon. We identified that the law had not been complied with. You can see what action we have told the provider to take at the back of the full version of the report.