Agincare UK Brighton

Agincare UK Brighton is a domiciliary care agency. It provides personal care to approximately 170 people living in their own homes in the community. The service supports people living in Brighton and Hove. Agincare UK Brighton supports people with a range of health and social care needs, such as people with a physical disability, sensory impairment or people living with dementia.

People’s experience of using this service:

People we spoke with gave us mixed feedback in respect to the care they received. They felt they were treated with kindness by their care workers and they felt safe. However, they did not feel the care received routinely met their needs and preferences. People’s care visits were often late or early, and on occasion cut short.

We found issues with staffing levels and the deployment of staff. Many of the issues in respect to staffing levels had been caused by the COVID-19 pandemic, with staff being off sick or needing to self-isolate.

Staffing levels and sickness had impacted negatively on systems designed for scheduling care visits. This meant that staff were not always able to routinely attend to people’s care calls on time and stay for the amount of time they were scheduled for. People’s assessed needs or preferences were not always met and they did not receive continuity of care.

People’s feedback was mixed in respect to feeling the service was well managed. Some people were happy with the care they received. However, others did not feel routinely involved in their care, or feel their concerns and issues were acted upon.

The provider was aware of the issues we identified at this inspection and had started to implement changes to drive improvement.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 10 January 2020).

Why we inspected

We received concerns in relation to the service providing regular care calls that met people’s needs and preferences. There was also an increased level of safeguarding concerns, incident of whistleblowing and complaints being made about the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the key questions of effective, caring or responsive. We therefore did not inspect these. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

About the service

Agincare UK Brighton is a domiciliary care agency that provides personal care and support to people living in their own homes, hostels and Brooke Mead extra care housing scheme. Brooke Mead is a single adapted building comprising of 45 self-contained flats which are managed by Brighton and Hove City Council.

At the time of our inspection, 171 people aged between their mid-thirties to their mid-nineties were receiving personal care and support from this home care agency. Some of these people were living with dementia, experienced mental ill health, had a learning disability or complex physical health care needs.

People’s experience of using this service

People told us they remained happy with the home care service they received from Agincare UK Brighton. A quote we received from a person using this home care service summed up how most people felt about the agency – “My regular carers are amazing…They can be relied upon at all times. I could not speak more highly of them.”

As recommended in our last inspection we saw the provider had taken appropriate action to improve the way they coordinated staffs scheduled visits. This ensured people now received continuity of personal care and support from staff who were familiar with their needs, daily routines and preferences.

People receiving a home care service, their relatives and staff were complimentary about the way the office-based managers ran the agency and how approachable they all were. The provider promoted an open and inclusive culture which sought the views of people using the service, their relatives and staff. The provider worked in close partnership with other health and social care professionals and agencies to plan and deliver people’s packages of care and support.

People were supported by staff who knew how to prevent and manage risks they might face and keep them safe from avoidable harm. Staff continued to undergo all the relevant pre-employment checks to ensure their suitability and fitness for the role. People received consistently good personal care and support from staff who were usually punctual and stayed for as long as it took to complete the tasks they were expected to do. People received their medicines as they were prescribed. The service’s arrangements for controlling infection remained effective.

People continued to receive personal care from staff who had completed training that was relevant to their roles and responsibilities. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Where staff were responsible for this, people were supported to maintain a nutritionally well-balanced diet. People continued to be supported to stay physically and emotionally healthy and well.

Staff treated people with dignity and respect. People were treated equally and had their human rights and diversity respected, including their spiritual and cultural needs and wishes. People were encouraged and supported to maintain their independent living skills and do as much for themselves as they were willing and capable of doing. Assessments of people’s support needs were carried out before they started using the service.

Care plans remained personalised, which ensured people received personal care that was tailored to meet their individual needs and wishes. People were encouraged to make decisions about the care and support they received and had their choices respected. Managers and staff understood the Accessible Information Standard and ensured people were given information in a way they could understand. People were satisfied with the way the provider dealt with their concerns and complaints. When people were nearing the end of their life, they had received compassionate and supportive care from this agency.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at the last inspection

The last rating for this service was good (published 3 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Agincare UK Brighton on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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. Staff had an understanding of respecting people within their own home and providing them with choice and control. People were supported at mealtimes to access food and drink of their choice if required. One person told us “I will decide what I want to eat that day, they will cook it for me, sometimes they will suggest something if I can't make up my mind “.

People’s needs were assessed and regularly reviewed and they received support based upon their needs and preferences. We found the support plans to be person centred and details recorded were consistent. Staff supported people to access health care services if required. Staff told us they knew people well and recognised if they were unwell.

There were clear lines of accountability. The service had good leadership and direction from the manager. Staff felt supported in their roles and felt the management team were approachable. Staff comments included “He has transformed it in here, he is always approachable and he will do everything he can to find a solution to any problem”. Another member of staff said “He really values the job you do, he appreciates how difficult the job is and is always there to support you”.

The manager and provider monitored the quality of the service by the use of regular checks and internal quality audits to drive improvements. Feedback was sought through surveys which were sent to people and staff. Survey results were analysed and any issues identified acted upon.

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 assessed. Staff observed the key principles in their day to day work checking with people that they were happy for them to undertake care tasks before they proceeded.

People were supported at mealtimes to access and prepare food and drink of their choice and were supported to undertake activities away from their home. One member of staff told us “I always ensure people have drinks available before I leave and they are in reaching distance for the person. This is all recorded in the care plans”.

The management team monitored the quality of the service by the use of regular checks and internal quality audits to drive improvements. Feedback was sought by the provider through surveys which were sent to people annually. People and relatives we spoke with were aware of how to make a complaint. Complaints were responded to with details of any action taken.