25 May 2022
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 Health and Social Care Act 2008.
The inspection was carried out by two inspectors and an Expert by Experience. Two inspectors visited the office location on 5 April 2022. The Expert by Experience made telephone calls to people and their relatives. 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 houses and flats. CQC does not regulate premises used for domiciliary care; this inspection looked at people’s personal care and support.
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service 24 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 or care manager would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was asked to complete a Provider Information Return (PIR) prior to the inspection and we reviewed the information in the PIR. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 13 people’s relatives. We spoke with, or received email feedback from, ten members of staff including the provider, the registered manager, the deputy manager and deputy accounts scheduler. The registered manager was not available to support us with our inspection at the time of our visit.
We reviewed a range of records. This included five people’s care records and medication records. We reviewed three staff member’s recruitment records to establish safe recruitment procedures were being followed. We looked at a variety of records relating to the management of the service, including policies and procedures.
Following the inspection
We continued to receive governance documents and people’s records for review from the registered manager.
25 May 2022
About the service
A&K Home Care is a is a community-based care provider that provides personal care to people living in their own homes. At the time of inspection there were 38 people in receipt of the regulated activity of personal care.
Everyone who received support at the time of our inspection 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.
People’s experience of using this service and what we found
More improvements were required in allocating and monitoring care calls, to ensure people always received their care calls on time, and for the agreed length of time. Staff did not always stay for the full length of people’s scheduled calls. Staff told us they felt more staff would improve the service. Recruitment processes were in place and recruitment checks were carried out before staff were appointed. This helped to ensure suitable staff were appointed to support people.
Staff had received training in safeguarding and knew the actions to take to keep people safe. Overall, people’s medicines were managed safely. The provider had infection control policies and procedures in place to guide staff on how to reduce the risk of infections.
Staff received induction and training in their role. 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.
The provider had made a number of improvements since our previous inspection. Governance systems had been put in place, care records had been developed, and improvements had been made in service delivery. The provider carried out regular audits of the service to oversee the quality of the care provided. The provider carried out competency checks to assess whether staff were working in line with best practice. However, we found more improvements were required to ensure people received a good quality service that met their needs.
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 requires improvement (published March 2021) and there were two breaches of the regulations in regulation 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The breaches related to risk management under safe care and treatment, and the governance and leadership of the service under good governance. After the last inspection we imposed conditions on the provider’s registration, requiring them to send us an action plan each month, showing how they were meeting the requirements of regulation 12 and 17. At this inspection we found the provider had completed actions on their action plan, and there was no longer a breach of Regulation 12 and Regulation 17. We found improvements were still required in Safe and Well Led and have rated these key questions as requires improvement.
Why we inspected
We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe, Effective and Well-led which contain those requirements. 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 remained as Requires Improvement.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for A & K Home Care on our website at www.cqc.org.uk.
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
We will continue to receive a monthly report on how the provider is continuing to meet the conditions on their registration, 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.