21, 24, 25 and 26 August 2015
During a routine inspection
We undertook an announced inspection of Avant (Ealing) 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 (Ealing) provides a range of services to people in their own home including personal care. At the time of our inspection 60 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 use a medicine administration record (MAR) chart to record medicines they had administered which were not provided in a blister pack.
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 management of the service.
We had 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 and relatives told us that their regular care workers knew their support needs and provided appropriate care. There were effective procedures in place in relation to the recruitment of care workers for Avant (Ealing).
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.
People using the service told us they felt comfortable when receiving support from the care workers in their home.
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 that 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, the Mental Capacity Act 2005 and monitoring the quality of the service. You can see what action we told the provider to take at the back of the full version of this report.