21, 24, 25 and 26 August 2015
During a routine inspection
We undertook an announced inspection of Avant Healthcare Services Limited on 21, 24, 25 and 26 August 2015. We told the provider two days before our visit that we would be coming because the location provides a domiciliary care service for people in their own homes and staff might be out visiting people.
Avant Healthcare Services Limited provides a range of services to people in their own home including personal care. At the time of our inspection 160 people were receiving personal care in their home. The care had either been funded by their local authority or people were paying for their own care.
This was the first inspection of the service at the location. They were previously registered at a different address.
The service 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.
There was a policy in place in relation to medicines but care workers did not always use a medicine administration record (MAR) chart to record medicines they had administered which were not provided in a blister pack. We looked at the daily records for eight people and saw the medicines for two people had not been recorded on a MAR chart.
There were procedures in place in relation to the recruitment of care workers but we saw in six out of the ten employment records we reviewed the employment history had not been checked to ensure it was accurate and the applicant had not been asked to confirm the information provided.
The provider had a policy and training in relation to the Mental Capacity Act 2005 but they did not have procedures in place to ensure appropriate actions were taken when a person using the service had been identified as unable to make decisions about their care.
The provider had systems in place to monitor the quality of the care provided but these did not provide appropriate information to identify issues with the quality of the service
We received mixed feedback from people when asked if they felt the service was effective and well-led with both positive and negative comments relating to communication with the service.
There was mixed feedback from people using the service in relation to the timekeeping of the care workers. Some people told us that the care workers always contacted them if the visit was going to be late while other people said they were not informed that a visit was going to be delayed.
People using the service felt the care workers treated them with dignity and respect when providing care. Some people told us they were happy with the care provided but one person felt the care workers were not aware of their support needs.
People using the service and relatives told us they felt safe when care was provided in their home and care workers knew what to do in case of an emergency.
The provider had processes in place for the recording and investigation of incidents and accidents. A range of detailed risk assessments were in place in relation to the care being provided and were up to date.
Care workers had received training identified by the provider as mandatory to ensure they were providing appropriate and effective care for people using the service. Also care workers had regular supervision with their manager and received an annual appraisal.
Support plans identified the person’s cultural and religious needs. The plans also identified the person’s preference to the language spoken by the care worker.
Detailed assessments were carried out to identify each person’s care needs before they started to receive care in their home. This information was used to develop a support plan for each person which was up to date.
There was a complaints process in place and people using the service were sent questionnaires to gain their feedback on the quality of the care provided.
We found breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 which related to the management of medicines, recruitment of care workers, the Mental Capacity Act 2005 and monitoring the quality of the service provided. You can see what action we told the provider to take at the back of the full version of this report.