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Inspection Summary


Overall summary & rating

Inadequate

Updated 23 August 2019

About the service:

Assisted Home living is a Domiciliary Care Agency. The care agency provides personal care and support to people living within the community. At the time of the inspection, there were eight people receiving support with personal care.

People’s experience of using this service:

Staff had not had appropriate recruitment checks to ensure they were of good character to support people. Staff had not received training and lacked knowledge which was important to keep people safe.

Care records and risk assessments were either not completed or had insufficient detail to guide safe care. Care was therefore not delivered in line with current standards. We saw that some risks have not been adequately addressed which put people at risk of harm. There were no formal processes in place to review or amend records and ensure they were appropriate.

Medicines were not managed safely. People had received ‘as needed’ medicines without reason. Medicine risk assessments were not in place for those people that took medicines themselves and were at risk of doing so. Medicine records were not completed in a safe way to ensure mistakes were not made.

People had access to health and social care professionals, however professional guidance was not recorded to guide more effective care. Where professional advice was recorded, it was not always followed.

We found ongoing concerns about the safety and governance of the service. There was a failure to create improvements at the service, despite an action plan being in place. These risks and lack of improvement raised concerns about the quality of personal care delivered by the service.

There were enough staff and people reported that staff arrived on time to support them. People spoke highly of the staff at the service and told us that they felt well cared for.Rating at last inspection: The last report was published on 21 March 2018. It was rated as ‘Requires improvement’

Why we inspected:

At the last inspection, we rated the service as ‘Requires Improvement’. The service provided us with an action plan, stating that they would make the required improvements. We completed this inspection to check whether the required improvements had been made. A comprehensive inspection was completed due to the amount of regulation breaches and previous concerns.

Enforcement:

At this inspection we found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This included regulations 12, 17, 18 and 19. These are continued breaches from our last inspection in March 2018.

Information about CQC’s regulatory response to the more serious concerns found in inspections and appeals is added to reports after any representations and appeals have been concluded.

Follow up:

We will continue to monitor the level of risk at the service until the next inspection visit.

The overall rating for this service is now ‘Inadequate’ and the service is therefore in ‘special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there

Inspection areas

Safe

Inadequate

Updated 23 August 2019

The service was not safe.

Details are in our Safe findings below.

Effective

Requires improvement

Updated 23 August 2019

The service was not always effective

Details are in our Effective findings below.

Caring

Requires improvement

Updated 23 August 2019

The service was not always caring

Details are in our Caring findings below

Responsive

Requires improvement

Updated 23 August 2019

The service was not always responsive

Details are in our Responsive findings below.

Well-led

Inadequate

Updated 23 August 2019

The service was not well-led.

Details are in our Well-Led findings below.