Archived: Ace Homecare Grimsby

Ace Homecare Grimsby is a domiciliary care service providing care and support to older people and younger adults; people who may be living with a learning disability or autistic spectrum disorder, dementia, mental health need, or a physical disability.

Not everyone using the service receives regulated activity; the Care Quality Commission (CQC) only inspects the service being received by people provided with 'personal care'; 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 130 people received the service, of which 95 were being supported with personal care.

The service has been developed and designed in line with the principles and values that underpin

Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People's experience of using this service and what we found

People were safe from harm. Systems, safe recruitment and effective risk management supported this. Sufficient numbers of staff were employed to support people with their needs, including handling medicines and keeping their homes clean.

Staff were trained, skilled and well supported by the provider. People had good relationships with the staff who protected their rights to lead a normal life. 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.

People told us staff were kind, caring and respectful. They felt staff championed their privacy and dignity and encouraged their independence in all aspects of life.

Staff were motivated and dedicated to provide person-centred care based on people's choices and preferences. People were supported to do the things they wanted to. Any dissatisfaction in receiving the service was addressed and resolved, and any support people needed with end of life care was understood and provided.

For people with a learning disability, the service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected these principles and values by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People had the benefit of a service that was positive and inclusive, where the registered manager and a management team, maintained checks on how well the service was provided. Documents held in the office were secure to ensure confidentiality of people's information, and staff respected people's confidentiality when they supported them.

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

Rating at last inspection

The last rating for this service was good (published 1 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

Ace Homecare Grimsby is a domiciliary care agency that is registered to provide personal care to people living in their own houses and flats in the community. It primarily provides a service to older adults. The office is situated in a central area of the town. At the time of the inspection the service was providing support to up to 95 people.

This inspection took place on 22 February 2017 and 2 March 2017 and was announced. The service was last inspected in January 2016 when it was found to be in breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the registered provider did not have effective recording and monitoring systems in place to ensure people were provided with support that was safe, effective, caring, responsive and well-led.

At this inspection we found improvements had been made to address the above breach of regulation and the service was now compliant with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

There was a registered manager for the service. 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.

People who used the service were protected from harm by care staff who had been safely recruited and provided with training to ensure they knew how to recognise and report potential abuse. Assessments about potential risks to people had been completed to ensure staff knew how to keep people safe. Training had been delivered to staff to ensure they knew how to administer medicines safely. People told us they received a service from staff who overall were consistent, reliable and did not rush.

Care Staff had been provided with training to enable them to perform and effectively carry out their roles. People told us care staff involved them in decisions and ensured their consent was obtained in relation to their tasks of personal care.

People told us they had developed positive relationships with care staff who treated them with courtesy and kindness and maintained their personal dignity. People told us their care staff respected their wishes for privacy and supported them to be as independent as possible. People’s support plans contained evidence of assistance provided to ensure their health and wellbeing was maintained.

People told us that overall they were happy with the service they received and were confident any concerns they might have would be appropriately addressed and resolved where this was possible. Some people told us communication from the office could sometimes be improved if care staff were going to be late.

Recording systems were in place to ensure the quality of the service was monitored. This included a range of audits and checks that enabled trends to analysed and helped improvements to be implemented when required. The service consulted and engaged with people who used the service to ensure their views could obtained to help it learn and improve. Staff told us there was a management culture that was open, approachable and positive and which listened and worked in partnership with people in order to help the service develop.

The service had a registered manager in post. 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.

This was the first inspection of this service since they had moved the office location. It is an established agency in the area and under the previous registration was compliant at the last inspection in 2013.

We found there was no clear system in place to monitor how the service was operating. For example, although the registered manager said they checked care records, time sheets and medicine administration records when they were returned to the office, there was no system in place to record their findings and what action had been taken to address shortfalls.

The registered provider had used annual surveys, care reviews and direct observation of staff to enable people to share their opinion of the service provided and check staff were following company polices. However, although we found the survey information had been reviewed and the outcome shared with people who used the service, not all shortfalls or concerns had been followed up and addressed.

Also we found some people’s care plans were not written in a person-centred style, some had not been updated to reflect changes in needs and not everyone who used the service had plans of care and assessments to support all their needs. This meant staff may not have guidance in how to meet people’s needs, staff may not support people in the way they preferred and there was a risk important care could be missed.

These issues meant the registered provider was not meeting the requirements of the law regarding monitoring the quality of the service and assessing and planning care for people. You can see what action we told the registered provider to take at the back of the full version of the report.

In recent months, there had been organisational restructuring within the senior management team and changes in service provision. Staff had been informed of the changes and told us they were supported through this time. Staff felt comfortable about sharing their views and talking to the registered manager if they had any concerns or ideas to improve the service provided. Staff demonstrated a good understanding of their role.

We found staff were recruited safely and in sufficient numbers to meet the needs of people who used the service. People told us they received their care from the same care workers who generally arrived on time and supported them in a caring and unrushed manner. People made positive comments about the staff team. They told us, “Staff are reliable and helpful” and “I get the same carers and they are all lovely and kind.”

Staff demonstrated a good understanding of the Mental Capacity Act 2005 and consent was sought for care support, although formal systems to assess people’s capacity needed to be put in place.

The staff had received an induction and essential training at the beginning of their employment and we saw this had been followed by periodic refresher training to update their knowledge and skills. Although we found some gaps in refresher training and appraisals, following the inspection the registered manager confirmed these had all been scheduled for completion in February 2016.

People told us they were happy with the quality of their care and told us their workers were kind and caring. Relatives also praised the care staff’s friendliness and the respect they showed to people. People’s dignity and privacy were upheld, and they were helped to keep as independent as possible.

The service worked well to help ensure people received effective health care support from other agencies and action was taken when there were changes. People who required assistance to take their medicines were provided with safe support. People told us they got the support they needed with their meals and drinks.

We found people who used the service were protected from the risk of harm and abuse because staff had received safeguarding training and they knew what to do should they have any concerns.