Background to this inspection
Updated
23 July 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team
The inspection was completed by an inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own accommodation.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
One day of this inspection was a site visit at the agency offices and was announced before our visit. This was to check on the situation regarding COVID-19 and to ensure that the provider or registered manager would be in the office to support the inspection.
What we did before inspection
Before the inspection we checked the information that we held about the service. This included statutory notifications sent to us by the provider about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send us by law.
We did not ask the provider to complete 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 also obtained feedback from the local authority and healthcare professionals. We used all this information to plan our inspection.
During the inspection
We visited the agency offices on 25 May 2021 to look at records and speak with the registered manager and nominated individual for the provider. Due to the increased risk of cross-infection we were unable to complete more extensive observations on this day and asked for other information to be sent to us.
We spoke with eight people being supported by Apollo Care South Liverpool and 11 staff, including the registered manager, the nominated individual. Care staff conversations were carried out by phone.
We looked at a range of documentation including four people's care records, medication records, staff files, accident and incident records, health and safety records, audits and records relating to the quality checks undertaken by staff and other management records.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data, risk assessments and quality assurance records.
Updated
23 July 2021
About the service
Apollo Care South Liverpool is a domiciliary care service that provides personal care to people in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. The service was supporting 41 people at the time of the inspection.
People’s experience of using the service and what we found
Some aspects of managers roles and regulatory requirements had not been met. Prior to the inspection we had been concerned about the outcome of a safeguarding investigation conducted by the Local Authority. This raised issues around the effective management and running of the agency. We asked the provider to investigate, however the report produced raised issues around the thoroughness and impartiality of the investigation. The providers policy used for carrying out the investigation needed review and updating.
Other regulatory requirements were not always complied with. We identified statutory notifications should have been submitted to CQC as a measure of monitoring the quality and safety of care people received.
Staff spoken with displayed an understanding of safeguarding principles and reporting. However, we found safeguarding recommendations made after one [initial] investigation had not been followed by the provider, which may have caused potential risk for one person and staff.
The registered manager and nominated individual advised us that, as part of ongoing review and lessons learnt, they are reviewing the management and running of the service and would advise us of changes to be made.
People reported good support regarding the management of their medicines and told us they got their medicines on time. The medications records reviewed supported best practice. Staff administering medicines were suitably trained and competent.
We found ongoing checks of people’s home environment helped ensure people were safe. Risks associated with people’s care were mostly identified and managed to minimise harm. Supporting care records identified most key risks and there were plans in place to help keep people safe.
The service was staffed appropriately at the time of the inspection. Staff employed had been recruited safely and most had worked for some time for Apollo Care South Liverpool. This helped to maintain a consistency of care for people.
People's experience of using the service was positive. People received the care and support they needed when required. The feedback we received showed staff were helpful and kind and treated people with dignity and respect. One person commented, “Yes definitely [I feel safe]. Carers always act appropriately and are very friendly.”
Rating at last inspection
The last rating for this service was Good (published 8 January 2020).
Why we inspected
The inspection was instigated following background concerns regarding a safeguarding investigation and outcome. This raised issues around the running of the agency and ongoing safe standards. The Commission is aware that the provider disputes the content of the local authority safeguarding investigation.
A decision was made for us to inspect and examine those risks. We undertook a focused inspection to review the key questions of safe and well-led only.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed to Requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Apollo Care South Liverpool on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.
We have identified a breach of regulation as the provider had not met some regulatory requirements in the governance and running of the service.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information, we may inspect sooner.