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Arbour Care Requires improvement

This service was previously registered at a different address - see old profile

Reports


Inspection carried out on 2 September 2019

During a routine inspection

About the service

Arbour Care is a domiciliary care agency providing 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. At the time of the inspection 29 people were receiving personal care for 24 hours per day who had complex and multiple needs.

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

Some support plans lacked details and were not always up to date. People did not always have relevant risk assessments in place.

Staff knew people well, however, the details that staff were knowledgeable about were not always documented in the care plans. Records were not always accurate or up to date and audits were not always robust at identifying the shortfalls in records.

Some improvements had been made to medicine administration practises and policies since the last inspection.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. Some of the discrepancies in relation to best interests meetings were rectified immediately in the days following the inspection.

People were supported by caring staff that treated them with respect and dignity.

People told us they felt safe being cared for by staff, and described staff as caring people that they compared to family members. Staff were aware of how to identify different forms of abuse and report any safeguarding concerns.

Arrangements were in place to ensure suitable numbers of staff were in place to meet people’s needs. Safe recruitment practises were in place, as well as regular refresher training and supervisions were available to staff to ensure a standard of training was maintained.

People were kept safe from infection by staff who were regularly trained in the prevention of spread of infection and the provider had an infection control policy in place.

People were supported to make their own choices about their care and be independent. People were supported to pursue their hobbies and interests. Staff sought people’s consent and supported them in a way that met their preferences.

Accidents and incidents were recorded and any learning from lessons were shared with staff.

Health care professionals were involved in people’s care. The registered manager involved staff, people and other stake holders in service development. Staff stated they felt supported by the registered manager and the provider.

The service is in breach of Regulation 17 of The Health and Social Care Act (Regulated Activities) Regulations 2014 in relation to governance.

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 28 September 2018) and there was a breach of regulation 12. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulation 12. However, at this inspection the provider was found to be in breach of regulation 17.

Why we inspected

This was a planned inspection based on the previous rating.

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.

Inspection carried out on 2 August 2018

During a routine inspection

Arbour Care is a domiciliary care agency. It provides live-in personal care to people living in their own homes in the community. It provides a service to older and younger people some of whom may have a with a learning or physical disability. At the time of our inspection the service provided a regulated activity to 27 people.

There was a registered manager in post at the time of the inspection. 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.

Medicines were not always managed in a safe way which put people at risk. However, people did say that they received their medicines when needed. Medicines audits not effective in identifying the shortfalls.

Daily notes relating to people’s care was not person centred. We have made a recommendation around this.

People told us that they felt safe. Relatives felt that their family members were safe with staff.

Recruitment process were robust and staff understood what they needed to do to protect people from the risk of abuse.

There were sufficient levels of staff to support people. Risk assessments were in place for people and staff were aware of how to reduce risks. Staff were following good infection control. Accidents and incidents were recorded. The registered manager was asked to ensure that these records were kept centralised so that analysis could be undertaken.

The principles of the Mental Capacity Act were being followed and staff ensured that they gained consent from people before delivering care.

Staff had the training and supervision necessary to carry out their role. People felt that staff were effective and understood what care they needed to deliver. Staff worked with health care professionals to ensure that people were supported with the health care needs. This included being supported with their food and hydration needs.

A full assessment of people’s needs took place before people started using the service. Care plans were detailed and people were fully involved in the planning. Care plans were regularly reviewed and updated. Staff understood the needs of people and were effective in communicating changes in people’s care. People were supported to access the community.

People and relatives felt that staff were caring and respectful. People felt that staff assisted with the independence and included them in any decision making. People and relatives developed positive relationships with staff.

People understood how to make a complaint. Complaints were investigated and actions taken to resolve complaints. Other audits and quality assurance were robust and used to make improvements to the care provided. People and staff thought the leadership of the service was good. Staff felt supported and valued. Staff understood the ethos of the service.

The service worked closely with other agencies outside of the organisation. The registered manager ensured that notifications were sent to the CQC where necessary.

This was the first inspection at the service. There is one breach of regulation. You can see what action we told the provider to take at the back of the full version of the report.