The Care Quality Commission

Archived: Abicare Services Limited

The Wain House, Howton, Pontrilas, Herefordshire, HR2 0BG

Provided and run by:
Abicare Services Limited

All Inspections

16 October 2012

During an inspection looking at part of the service

We did this inspection to check what Abicare Services Ltd had done to make improvements at the Hereford branch following our previous inspections in February and July 2012. At those inspections we had found that the provider was not meeting required standards in the four areas we looked at. These were care and welfare, staff recruitment, staff support and training, and monitoring the quality of the service.

After our inspection in July 2012 we issued warning notices about staff recruitment and management. We repeated compliance actions for care and welfare and staff training. This was because some improvements had been made by the service in those areas.

This inspection identified that while there had been some improvements, overall the service was not meeting all of the required standards we checked. We met with the provider after the inspection to discuss their plan for improving the service. We have referred to those discussions within this report. The provider gave us firm assurances during this meeting that they were taking robust action to make sure that the service improved and became compliant with legislation. In light of this we made a decision that we would not at this stage take further formal action against Abicare Services Ltd. This report tells the provider how they were failing to meet the required standards. They must now send us an action plan and we will return to the service to check that the necessary improvements have been made.

31 July 2012

During an inspection looking at part of the service

We did this inspection to check what the provider had done to make improvements at the service following our last inspection in February 2012. At that inspection we found that the provider was not meeting government standards in the four areas we looked at. These were, care and welfare, staff recruitment, staff training and management. We asked the provider for an action plan following that inspection but they did not send us one.

For this inspection we visited the office twice and spoke with the acting manager, the nominated individual and the organisation's business operations manager. We had contact with three other staff while at the office and looked at three people's care records and five staff records. After our visit to the office we spoke on the telephone with six people who used the service (or members of their family) and with four staff. We also considered information we were aware of through the local multi-agency adult safeguarding arrangements and records at the agency about complaints made by people who used the service or their relatives. This told us that in some cases people had not received the standard of care they had expected.

People who used Abicare for themselves or their relatives were generally positive about the service they received. People felt that their care was dealt with safely and that they were treated in a respectful way. People made comments such as 'they are very good on the whole' and 'the carers are pleasant to have in the house'. We heard from some people that the times that care workers arrived for visits could be irregular and that they did not always stay the correct amount of time. Some people told us that the amount of time allocated to care workers to travel from one call to another was not always long enough.

The care workers we spoke with considered that Abicare provided people with good care and said that they liked working for the agency. They told us that they had received induction training and some mentioned that there had been more training provided since our last inspection. The training information we saw confirmed this, although we found that not all staff had completed training in some important topics such as infection control and first aid.

The staff recruitment arrangements were not as robust as they needed to be. The company's recruitment policies and procedures were not always being followed and this had not been identified by the provider.

Abicare did not have a registered manager. The previous registered manager left in November 2011. There had been an acting manager in post since before our last inspection in February 2012. They had not applied to be registered with the commission. No evidence was available to show that senior managers from the organisation were overseeing the management of the service. The acting manager was not aware of any quality monitoring audits or reports by their line manager. There was no evidence that the organisation had identified the shortfalls we found during our visit as we would have expected them to do through their internal; quality monitoring processes. This meant that potential risks to people who used the service and improvements needed to make sure people received a good service were not being dealt with.

17 February 2012

During an inspection in response to concerns

We did this inspection because we received information that there was a breakdown of communication at the care service. The concerns listed included information that staff were not being properly trained, that calls were often missed and that care workers did not have enough information about the care needed by people they would be visiting. We were told that the on-call telephone was not always answered.

We visited the office where we spoke with the manager and two staff as well as looking at three people's care records and four staff records. After our visit to the office we spoke on the telephone with six people who used the service (or members of their family) and with seven staff.

People with experience of using Abicare for themselves or their relatives were generally positive about the service they received. One person's relative told us 'I can't speak highly enough of them'. People felt that their care was dealt with safely and that they were treated in a respectful way. People made comments such as 'they are an absolutely fantastic bunch of people' and that they were 'more than happy' with the service. Two people told us they had recommended the agency to other people.

Some people who used the service and some staff did not feel that messages were always passed on or dealt with quickly enough. One person who used the service told us, 'the carers are excellent but the organisation from the office can be a problem'. Another person told us that the office staff were 'quite pleasant but you don't always feel they are taking notice'. Some staff said that the office telephone was not always answered and the on call one was not always responded to either.

The care workers we spoke with were also generally positive and said that on the whole they felt equipped to provide people with the care they needed. All of the care workers we spoke with considered that people using Abicare generally received a good or very good service. They confirmed that they had received induction training and some said they had since received refresher training in important topics such as medication and moving and handling. In some cases however care workers said that they had not received follow up training since their initial induction. The information that was available in staff records did not assure us that care workers received the full range of training that they may need in their work.

In speaking to some of the care workers we learned that there was not always written information available in people's homes to guide them regarding the correct care to provide.

The staff recruitment records we checked did not provide evidence that all of the expected checks had been done by the agency before certain staff had started providing care to people.

Abicare does not have a registered manager at present. The previous registered manager left in November 2011. There was an acting manager in post when we did this inspection. They were not aware whether on not head office had plans to arrange for them to be registered. They were not aware of their individual responsibility to apply to be registered. No evidence was made available on the day of our inspection to show that senior managers from the organisation were overseeing the management of the service. The acting manager was not aware of any quality monitoring audits or reports by their line manager. There was no evidence that the organisation had identified the shortfalls we found during our visit.