Archived: Apex Community Care Ltd

Updated 7 October 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 5, 13, 19 and 27 June 2017 was announced. The inspection was announced to ensure that the registered manager or appropriate person would be available to assist with the inspection visit. The inspection team consisted of one adult social care inspector.

On19 June 2017 an adult social care inspector spoke with a relative of a person who used the service.

We reviewed other information we held about the home, including any statutory notifications we had received from the provider. Notifications are changes, events or incidents that the provider is legally obliged to send us within the required timescale. Before the inspection, we also contacted the relevant local authority social work teams safeguarding teams to gain their views of the service provided.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We looked at care records for people who used the service. We examined documents relating to recruitment, supervision and training records and various records about how the service was managed.

During the inspection we spoke to the registered manager, an external social health care professional and four support workers.

Updated 7 October 2017

This inspection took place on 5, 13, 19 and 27 June 2017. The inspection was announced to ensure that the registered manager or appropriate person would be available to assist with the inspection visit.

Apex Community Care Limited is a domiciliary care provider registered to provide personal care to people in their own homes. At the start of our inspection information provided from the local authority suggested the service supported two people however the service declared that only one person received personal care. This is the first time the service has been inspected.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

During this inspection we found the service had breached a number of regulations. The service had not undertaken the necessary checks to ensure staff were suitable to work with vulnerable people. Staff did not receive appropriate training to ensure the safe delivery of care and support. Supervisions and appraisals were not up to date. Identified risks were not always assessed and mitigated against. Safeguarding incidents had not always been recognised and referred to the local safeguarding authority. The service failed to maintain suitable records for the management of the service. We also found that the provider did not have effective quality assurance processes to monitor the quality and safety of the service provided and to ensure that people received appropriate care and support.

Staff were not trained in the safe administration of medicines, competency reviews were not conducted.

Accidents and incidents were not collated appropriately and analysed to ensure actions were taken to reduce future events.

Relatives told us staff treated people with dignity and respect. People who used the service were not proactively enabled to express their views about the care and support that they received.

Staff supported people to access external health appointments when required. People were supported to meet their nutritional needs.

Care plans were not written in a way that identified a person's wishes as to how they wanted their care to be provided.

The service did not have a business continuity plan to ensure people would continue to receive care in the event of an emergency.

The overall rating for this service is 'Inadequate' and the service is therefore in 'Special measures'.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their 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.