Background to this inspection
Updated
25 September 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by two inspectors and one Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we held about the service. This included notifications the provider is required by law to send us about events that happen within the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
During the inspection the Expert by Experience spoke with four people and two relatives by phone. An inspector visited two people at home. One of these visits was carried out jointly with two health and social care professionals and the other with a person’s relatives. We spoke with four social care professionals and the provider’s care coordinator and manager.
We reviewed six people’s care records which included assessments, care plans, medicines administration records and daily notes. We checked eight staff files along with staff rosters, training records and supervision notes. We reviewed the complaints the provider had received and records of quality monitoring.
After the inspection
We spoke with two professionals with knowledge of the service.
Updated
25 September 2021
About the service
Angel Care Solutions (UK) Ltd is a domiciliary care agency that provides personal care to people in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is 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 the service was supporting eight people with their personal care needs.
People’s experience of using this service and what we found
The provider’s planning for delivery of care was unsafe. Staff rotas revealed that people were at risk of not receiving appropriate care because managers had scheduled staff to deliver care to different people in different locations at the same time. In order for people to receive their care as planned the provider was deploying individuals who were not disclosed as staff to CQC during the inspection. This meant people continued to be at risk from potentially untrained, unvetted and unsafe staff.
People were not appropriately safeguarded. The provider did not follow local safeguarding adults guidance to keep people safe. As a result we raised two safeguarding alerts during our inspection.
Concerns remained about staff training and the records related to it.
In contrast to the staff rosters we were presented with, people and their relatives told us they did not always receive care visits from regular staff or staff named on the rosters.
The service continued to be poorly managed. Managers continued to have an inadequate knowledge of regulated activity, maintained inaccurate records and were not transparent. The provider failed to display its performance ratings.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was Inadequate (published 30 April 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Angel Solutions (UK) Ltd on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to governance, staffing, persons employed, duty of candour and displaying of ratings at this inspection. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.