All inspections: Abicare Services Ltd - Care Quality Commission

We inspected Abicare Services Ltd on 24 October 2016. It was a full comprehensive inspection which was also carried out as a follow-up to our previous visit in October 2015.AbicareServices Ltd is a domiciliary care agency providing care to people in their own homes. At the time of our inspection 42 people were receiving care and support from the service.

We had found four breaches of the regulations at our previous inspection in October 2015. At this inspection we aimed to see what measures had been taken to ensure the quality of the service had improved and check if these measures had been effective. The provider had told us that all the corrective actions specified in their action plans would have been implemented by the end of January 2016. During our inspection on 24 October 2016 we found that all the recommended actions had been completed.

There was a registered manager in post at 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.

Most aspects of safe recruitment practices, such as police identity and character checks, were in place. However, the provider had failed to gather full employment history of all of their prospective staff members. We brought it to the attention of the registered manager who addressed the issue immediately by updating staff files during the course of our inspection. Following our inspection, the provider sent us scans of updated staff files.

At this inspection we found that arrangements were in place to monitor staff attendance at work and to minimise the number of missed calls. Most of the people told us that staff had been available to attend a call and to provide care to people at the agreed time. A person told us, “Staff come more or less on time”.

People we spoke with told us that they felt safe when staff supported them in their homes and that staff knew how to support them. Staff were able to tell us about the needs of the people they provided care for and their roles and responsibilities in keeping people safe. People had risk assessments in place to keep them safe whilst enabling them to be as independent as possible.

People’s prescribed medicines were safely managed by staff. Relevant systems and protocols in place ensured people received their medicines as prescribed. Staff’s competence was reviewed regularly to ensure that the medicines were administered safely.

Staff received an induction to their work, close supervision, on-going training and ongoing support from senior staff and agency management.

The registered manager and staff had a clear understanding of the Mental Capacity Act 2005. They were knowledgeable about protecting legal rights of people who did not have the mental capacity to make decisions for themselves. The service acted in accordance with legal requirements to support people who may lack capacity to make their own decisions.

People were provided with sufficient amounts of food and drink, with all recommendations from health care professionals being followed. People were supported by staff to access a range of health care services which ensured their health was monitored and maintained.

Assessments were undertaken to identify people’s support needs and care plans were developed outlining how these needs were to be met. We found that care plans were detailed, which enabled staff to provide the individualised care people needed. People told us they were involved in developing their care plans. They were also consulted about the way their care was delivered to ensure their wishes and preferences were met. Staff were knowledgeable about people’s backgrounds, life histories, preferences and routines.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included satisfaction surveys, spot checks and internal audits. We found that most of people were satisfied with the care and support they received.

The staff were pleased to work for the provider and felt supported in their role. The provider promoted an open culture where both staff and people using the service could raise concerns without fear of being frowned upon. People knew how to complain and felt their complaints would be investigated and responded to.

We inspected Abicare on the 12 October 2015. Abicare is a domiciliary care agency that provides care to people in their own homes. This service was registered in January 2015 so had not yet been operating for a full year. The service also included a ‘crises team who take referrals from the local authority for people who require short term support in crisis situations. This was an unannounced inspection. At the time of the inspection there was an ongoing effort to successfully embed this service as part of the registered location. A difference in the cultures of both services had led to some challenges that impacted on staff’s ability to do their role effectively.

There was a registered manager in post at the service who had been in post at the point of registration. 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 were not always deployed in a way that met people needs and the impact of this was some people did not always feel safe. Risk assessments did not always reflect people’s changing needs and the systems used to mitigate these risks were not always effective. People were protected from the risk of harm and abuse as staff understood their responsibilities in relation to safeguarding and how to raise concerns.

Staff felt if they needed support then they could ask for it. However formal supervision was not always available or effective. Not all staff understood the principles of the Mental Capacity Act (Act) 2005. The MCA is a legal framework that protects the rights of people who may not be able to make particular decisions themselves. We have recommended that the service familiarise themselves with the MCA code of conduct.

Some people we spoke with spoke highly of the level of skill and experience of some staff. However others did not feel all staff had the right skills and experience. People benefited from a service that accessed appropriate health care as and when people required it.

People and their relatives described staff as caring. One person told us how their independence was supported by a caring staff team. Staff we spoke with valued their relationships with the people they supported and spoke about them warmly and respectfully.

The service used detailed and person centred assessments to obtain information about people and their preferences. However, this information was not always followed in a way that made people feel they were understood. Concerns raised did not always lead to action taken to improve people’s experience.

The service had systems in place to monitor the quality and safety of the service but they were not always effective. There were no action plans to enable the service to improve even though areas requiring improvement had been identified.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we took and what action we told the provider to take.

Archived: Abicare Services Ltd

All Inspections

24 October 2016

During a routine inspection

12 October 2015

During a routine inspection

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we took and what action we told the provider to take.