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Inspection carried out on 10 May 2017

During a routine inspection

The inspection took place on the 10 May 2017 and was announced. The provider was given 48 hour’s notice because the location provides a domiciliary care service. We wanted to be sure that someone would be in to speak with us.

Agincare UK Brighton provides domiciliary care and support for people in their own home. The service provides personal care, help, and support to people with a variety of needs in Brighton and the surrounding areas. The service is located in the centre of Brighton and is situated centrally to

the geographic area it serves. At the time of our inspection 193 people were receiving a care service with an age range between 27 to 102. This included older people, people living with dementia and people with a physical disability.

The service did not have 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. The new manager in post was currently registering with us.

People and relatives gave us a varied response on whether they saw regular care staff and were advised in advance of who was coming and at what time. Comments included “I get a variety of girls, I have got my favourites but I do like them all, we used to get a rota but it stopped so now I don't know who is coming”, “I get the same girls and they are usually on time, they have never let me down”,” I get all different carers, I do have a rota but I’ll be honest it's not always correct” and “Rotas are not always regular”. We have identified this as an area of practice that needs improvement.

Staff had a firm understanding of how to keep people safe and there were appropriate arrangements in place to manage risks. One member of staff told us”I became aware that something was bothering my client, they weren’t the same, a bit worried and a bit anxious. When I investigated further I discovered some rogue builders had been round and had got them to sign up to a big building project, I immediately contacted the office who contacted their family to stop the work going ahead”. There were enough staff employed to care for people safely and the provider had robust recruitment procedures to ensure that staff were suitable to work with people. People were supported to receive their medicines safely in line with current regulations and guidance.

Staff told us they had received training and were confident to meet people’s needs and told us that communication with senior staff was good. One member of staff told us “The induction helped me with my knowledge and I was taught how to operate the hoists, it was good because if I wasn’t sure they were patient and happy to go over it with me”. Staff had a good understanding of the responsibilities with regard to the Mental Capacity Act 2005 (MCA). Records confirmed that where people lacked capacity to make specific decisions the service was guided by the principles of the MCA to ensure any decisions were made in the person’s best interests.

Staff felt fully supported by the registered manager to undertake their roles. They were given training updates, supervision and development opportunities. New staff trained alongside experienced staff on support calls. Competency checks were completed to ensure staff were delivering the correct care and support for people. One member of staff told us “We have regular supervision and talk about any issues or situations we may be having problems with”.

People told us that staff were kind and caring. Comments included “ All of them in turn are kind, I am very satisfied it's been life changing for me to have had this care and support”, “They are kind and funny they make me laugh, cheer me up. I look forward to them coming”. People confirmed staff respected their privacy and dignity

Inspection carried out on 4 May 2016

During a routine inspection

The inspection took place on the 4 and 6 May 2016 and was announced. The provider was given 48 hour’s notice because the location provides a domiciliary care service. We wanted to be sure that someone would be in to speak with us. Six months prior to the inspection Agincare UK Brighton had merged with another domiciliary care company in Brighton and was still going through a transition period.

Agincare UK Brighton provides domiciliary care and support for people in their own home. The service provides personal care, help, and support to people with a variety of needs in Brighton and the surrounding areas. The service is located in the centre of Brighton and is situated centrally to the geographic area it serves. At the time of our inspection 167 people were receiving a care service with an age range between 25 to 105. This included older people, people living with dementia and people with a physical disability.

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.

People and relatives feedback regarding the management of the service was varied and we were told that communication from office staff had been varied in quality. One person told us “I’m phoned by the management occasionally, not a lot though”. Staff were supported by the registered manager. There was open communication within the staff team, however staff had not attended regular staff meetings to keep them up to date with changes through the merger. We have identified this as an area of practice that needs improvement.

Not all staff had received regular competency spot checks and supervisions. One member of staff told us “I don’t receive supervision as often as I should, but if I have any problems I speak to a supervisor”. Another member of staff said “I haven’t had supervision since Agincare took over, I do get asked if everything is ok”. We have identified this as an area of practice that needs improvement.

People and relatives gave us a varied response on whether they saw regular care staff and were advised in advance of who was coming and at what time. One person told us “The carers are good but the office staff are not good at letting you know why a carer is late”. We have identified this as an area of practice that needs improvement.

Needs assessments were undertaken and care plans developed to identify people’s health and support needs. Although there was a plan in place not all care plans had been reviewed and updated. We have identified this as an area of practice that needs improvement.

People told us they felt safe, that staff were kind and the care they received was good. One person told us “I feel totally safe, they are wonderful carers, no problems”. Every person we spoke with felt their carers were kind and caring. One person told us “I find all the staff very friendly and helpful and I couldn’t wish for better carers”.

Assessments of risk had been undertaken and there were instructions for staff on what action to take in order to mitigate them. Staff knew how to recognise the potential signs of abuse and what action to take to keep people safe. The registered manager made sure there was enough staff at all times to meet people’s needs. When the provider employed new staff at the service they followed safe recruitment practices.

The provider had arrangements in place for the safe administration of medicines. People were supported to receive their medicine when they needed it. People were supported to maintain good health and supported to access health care services if required.

The provider considered peoples capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been