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Advanced Care Yorkshire Limited Requires improvement

We are carrying out a review of quality at Advanced Care Yorkshire Limited. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 17 January 2019

The announced inspection took place on the 27, 28 November and the 3 and 4 December 2018.

Advanced Care Yorkshire Limited 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 adults with a variety of needs.

Not everyone using Advanced Care Yorkshire receives regulated activity; 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 take into account any wider social care provided. At the time of inspection 78 people were receiving a regulated activity.

There was a registered manager in post at the time of inspection. The registered manager was also the provider. 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. The registered manager and the training manager were present during the office visits to support the inspection. The training manager took on a variety of roles within the organisation including supporting the registered manager with the running of the service.

We found there was no robust governance and monitoring of the service. There was no formal system to audit parts of the service to ensure compliance and continuous improvement. Spot checks were carried out by the service. However, these were not consistently completed so did not always identify areas found at the inspection. There was no monitoring of accidents and incidents to monitor for trends. When incidents occurred, we found there was no records available.

Person centred detail was not always included in people's care records and some people did not have care plans in place. People's care records did not reflect their needs or detail how people like to receive their support. Staff told us they did not always read peoples care plans. This meant staff did not always have information to provide people with person centred care.

We found not all risks relating to the health and safety of people who used the service were assessed and managed. Risk assessments were not always completed when a risk had been identified and control measures were not always in place to try to reduce the risk to people.

There was no call monitoring system in place to monitor late or missed calls. This meant the service relied on people or their families to inform them if staff did not attend the call. We received mixed views regarding staff attending calls on time. During the inspection we attended a call where a staff member was 20 minutes late.

We reviewed people’s medication administration records and found gaps in recording. There was no evidence people did not receive their medication as prescribed.

Staff were not receiving regular supervisions or appraisals as in line with the company’s policy.

People told us they felt safe. Staff had knowledge of safeguarding procedures. People and relatives told us staff were caring and their privacy and dignity was respected.

Staff attended an induction programme which included training and shadowing, and received ongoing training the provider classed as mandatory.

Staff told us they felt supported by the management team. The manager told us they communicated with people through newsletters.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 during this inspection. You can see what action we told the provider to take at the back of the full version of the report.

Inspection areas

Safe

Requires improvement

Updated 17 January 2019

The service was not always safe.

Risk assessments were not always completed when a risk was identified. There was no call monitoring system in place to ensure people received their required calls. There was no monitoring of accident and incidents.

Effective

Requires improvement

Updated 17 January 2019

The service was not always effective

People were not receiving regular supervision and appraisal in line with the company�s policies and procedures. When relatives had consented to care it was not always documented if they had the legal right to do so.

Staff were receiving induction and ongoing training.

Caring

Good

Updated 17 January 2019

The service was caring.

People we spoke with were positive about the staff

and how caring they were. We observed positive interactions between staff and people who used the service.

Responsive

Requires improvement

Updated 17 January 2019

The service was not always responsive.

Care plans did not always contain person centred information and some people did not have care plans in place. When people raised concerns, we could not see records of what action had been taken.

Well-led

Requires improvement

Updated 17 January 2019

The service was not well led.

There was a lack of robust governance and monitoring of the service. Regular auditing of the service was not carried out. Concerns found during inspection had not been identified. Feedback was not consistently sought.