Apollo Care (South Wirral)

Apollo Care South Wirral is a domiciliary care agency. It provides personal care to 30 people living in their own houses and flats in the community. It provides a service to older adults in the geographical area of South Wirral.

The service required and had a registered manager. 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.

During our previous inspection in November 2016 we had found a breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The overall rating for the service was ‘requires improvement’. Following the inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions; ‘Is the service safe?’ and ‘Is the service well-led?’ To at least a rating of good.

At the previous inspection we saw that systems had not always been followed to ensure that staff had been safely recruited. At this inspection we saw that there had been improvements in this area and the service was compliant with all the health and social care regulations. The breaches we identified in October 2016 had been addressed, the overall rating is now ‘good’.

People and their relatives told us that they felt safe with the care provided by Apollo Care South Wirral. One person told us, “Their support helps me to stay at home and feel safe.” People’s care needs were assessed and the times of calls were arranged with them. People told us that the service they received was reliable and flexible to their needs. People told us that the service could be relied upon. If an unforeseeable event occurred and the carer was going to be more than fifteen minutes late the person was contacted by telephone and if needed an alternative carer was arranged.

The service had enough staff to meet the needs of the people supported. Staff told us that they had sufficient time for travel in between calls and to give people the full allocated time for their call. This meant that staff were not rushed and helped to ensure that staff had time to give people the care and support they required.

To ensure the quality of care provided to people the registered manager arranged for unannounced spot checks to be completed

There were procedures in place at the service to safely recruit new staff members. Staff also received training in safeguarding vulnerable adults as part of their initial training along with periodic refreshment of this training. People received their medication in a safe manner.

We saw that appropriate risk assessments were in place in people’s care files for different aspects of people’s care. The registered manager kept a record of any accidents, incidents or near misses. The record of incidents was detailed and we saw examples of when incidents had been learnt from, information fed back to staff members and actions taken to keep people safe.

Staff members told us that they felt effective, enjoyed and were well supported in their roles. New staff received a thorough induction which included training, reviewing the policies of the service and shadowing an experienced member of staff for a period of time. Staff received training that was appropriate to their role. Staff praised the quality of the training and training opportunities available to them.

People told us they felt well cared for by staff who were kind and patient. There was a caring culture within the service. One person told us, “I don’t know what I would do without them. I look forward to them coming, I enjoy their company and know them off by heart.”

Staff were vigilant to people’s health needs and made appropriate referrals. People were safely supported with their eating and drinking if they needed support with this. We saw that people’s privacy and dignity was respected by staff and in the way their service was delivered.

Each person had a care plan that was individualised and contained specific guidance on their needs, preferences and how to keep the person as safe and healthy as possible. People were involved in writing their care plan. We saw that people’s care plans were regularly reviewed with them and that on occasions these reviews had led to changes being made to the care plan in response to people’s feedback. When we visited people, we saw that their care plans reflected the care they needed.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. People told us that they were listened to by staff.

The registered manager was knowledgeable about people’s support and care needs. She was friendly and showed a personal interest in people. There was a positive culture in the office and amongst staff members. To ensure the quality of care provided to people the registered manager arranged for a series of audits to check the quality and safety of the service being provided. The registered manager also communicated with people making visits to their homes, along with using newsletters and questionnaires.

Apollo Care South Wirral provide personal care for 13 people living in their own homes in the geographical area of South Wirral. On the first day we visited the organisation’s office; on the second day we visited five people in their homes who were happy to speak with us about the care they received.

The service required and had a registered manager. 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.

During our inspection we found a breach of Regulation 19 (2) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Recruitment procedures were not operated effectively to ensure that persons employed were suitable to work in health and social care. You can see what action we told the provider to take at the back of the full version of the report.

We saw that there were procedures and systems in place to recruit new staff safely. However we found that these had not always been followed. This meant that the registered manager did not have oversight of and could not be assured that they had consistently made safe recruitment decisions.

People told us they felt safe with the care they received in their home. People’s relatives told us they had confidence in the care and support their family member received. They also said the service they received was reliable. One person said, “They have never missed a call”.

There were sufficient staff employed to meet people’s care needs and to be reliable in the visits planned to people’s homes. People had their calls at the time that had been agreed and recorded in their care plan, in accordance with their needs and wishes. The registered manager showed us and staff confirmed that they received a weekly rota; this plan allowed for appropriate travel time between calls. The people using the service told us that also they received a weekly rota from the organisation showing them who was making the visits the following week. One person said, “I have a rota showing which staff are coming. I know them all”.

People told us they always received the full allocated time for their call. When care was required from two staff member’s people told us two staff always arrived.

People and their relatives told us they thought that the care staff were sufficiently trained and had the skills needed to be confident in their role. Staff told us they felt well supported and received initial training, induction and time shadowing an experienced staff member. They also received refresher training, unannounced ‘spot check’ assessments, supervision meetings and team meetings to support their ongoing development.

Staff received training in safeguarding vulnerable adults. Those that we spoke with were knowledgeable with regard to safeguarding. They knew who to contact if they had any concerns and which organisations they could go to outside of Apollo Care South Wirral if appropriate to do so.

We saw that people were supported with their health care needs and to access medical professionals when necessary. People who were assisted with their medication had this documented in their care plan. We saw that records were kept of the medication administered in people’s care plans and on a medication administration record (MAR). The organisation supplied care staff with gloves, aprons and any other equipment needed to complete their role safely. As part of their identified care some people were supported with purchasing and preparing their meals. People told us this was done well.

We saw that appropriate risk assessments were in place for the different aspects of people’s care. The registered manager also kept a record of accidents, injuries and any near misses that happened, along with a record of any action taken to keep people safe.

We saw that the organisation applied the principles of the Mental Capacity Act in the delivering of their care. People we spoke with told us they were treated with respect, their consent was sought and they were involved in the planning of their care including any referrals made. As part of people’s initial assessment, their ability to consent to their care was ascertained.

People told us they felt well cared for. One person when speaking about their care staff, told us, “They are like a family”. One person’s relative told us, “They are all lovely; there is not one of them we don’t like. A few are like friends now”.

People told us they were treated with kindness and patience. They told us of examples of this in their care along with being treated with dignity and respect. We saw that the organisation had received many written compliments from people and their families. The service had provided end of life care for some people in their own homes which had been praised. We were told this was planned in line with the person’s wishes.

The registered manager promoted a caring culture. Staff were recognised who excelled in being caring. People also told us they felt well informed by the organisation and this gave them reassurance. People and their families were involved in assessing their care needs and preferences and creating a care plan. We saw that these plans were reviewed periodically with people. We looked at some people’s care plans and found they contained the person’s agreed schedule and had individualised and specific guidance on the person’s needs, preferences and how to keep the person as safe and healthy as possible.

People and staff told us the service was well led and they found the registered manager approachable. The registered manage told us they liked to be personally involved in the reviews of people’s care plans. They told us that it was an opportunity to stay in touch with people and gain feedback in person about the quality of their care. We looked at the organisations records of compliments and complaints. We saw that complaints had been recorded, addressed and responded to in a timely manner.

The registered manager completed a series of audits. They had recently started auditing people’s medication administration records and daily communication sheets. The manager had oversight of when people’s care plans were reviewed and staff supervisions and training. We found that the audits of staff files had not been effective in highlighting gaps in the system ensuring staff were recruited safely.

We saw that when incidents had occurred in delivering care to people these had been recorded and the registered manager had taken appropriate action. We found the manager to be open, candid and quick to respond to concerns highlighted.