At Home Support Services Limited

Updated 21 September 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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by two inspectors and one 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. The Expert by Experience supported this inspection by making telephone calls to people and relatives to gain their feedback.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

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

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 22 June 2021 and ended on 12 July 2021. We visited the office location on 22 June 2021. Following the on-site inspection, we completed the inspection via phone and e-mail. On 24 June 2021 telephone calls were made to relatives to gain their feedback. On 12 July 2021, verbal feedback was provided to the registered manager.

What we did before inspection

We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with the registered manager and reviewed a variety of records including five peoples care plans and risk assessments, three people’s medicines records and four staff files including recruitment and supervision records.

After the inspection

We spoke with two people that used the service and seven relatives. We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 21 September 2021

About the service

At Home Support Services is a domiciliary care agency providing personal care to older people living in their own homes. At the time of the inspection there were 11 people receiving support from the service.

People’s experience of using this service and what we found

People and relatives told us they were happy with the care that was provided by At Home Support Services and felt staff knew them well and understood their needs.

The provider had failed to ensure there were accurate and contemporaneous records of the care being provided to people. This included ensuring medicines and people’s risks were documented and securely maintained. Auditing systems were ineffective and failed to pick up issues found at this inspection.

We have made a recommendation around medicines management.

People told us they received their medicines on time. Staff had received training on medicines administration. Staff understood safeguarding and how to report concerns if they felt people were at risk of abuse or harm. Staff were recruited safely, and appropriate background checks completed prior to starting work. Staff had received training in COVID-19, the use of PPE and infection control. Staff had regular access to PPE.

Staff were supported in their role through regular supervision, training and appraisal. People and relatives felt staff were well trained and understood people’s care and support needs. People were supported to eat and drink where this was a required need. 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.

People and relatives were complimentary of the registered manager. We received positive feedback around communication with the office and being able to discuss any concerns or issues. Staff also felt supported in their role. There were regular surveys to gain people, relatives, healthcare professionals and staff feedback. The service worked in collaboration with external healthcare agencies for the best interest of people.

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

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 06 March 2020). The service remains rated requires improvement. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations. This service has been rated requires improvement for the last four consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

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 have identified a breach in relation to regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was around ensuring effective auditing systems and maintaining accurate and contemporaneous records of people’s care.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.