Archived: AC Homecare

Updated 16 March 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

The inspection was carried out by one inspector 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.

Service and service type

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

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 4 February and ended on 26 February. We visited the office location on 4 February.

What we did before 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 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. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

We spoke with five people who used the service and four relatives about their experience of the care provided. We spoke with eleven members of staff including the provider, manager, care co-ordinator and care workers.

We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 16 March 2021

AC Homecare is a domiciliary care agency providing personal care to 31 people at the time of the inspection.

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.

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

The management team did not always notify appropriate agencies of safeguarding concerns in a timely manner. Where concerns had been raised these were not always investigated effectively. This was highlighted as part of the inspection feedback and the management team looked into these concerns.

Where people had support with medicines this was not always managed efficiently. Medicines administration records were not always completed, and people’s medicines were not always reordered promptly. This meant people did not have their medicines when required.

People had mixed views when asked about staff knowledge of their roles. Staff had not received all of the mandatory training set out by the provider, although the provider completed observations and competency checks.

Staff had access to personal protective equipment (PPE) and were tested for COVID-19 in line with guidance. People said the majority of staff were using safe practices when using PPE, although there were times where staff did not wear the PPE correctly. Staff were not cohorted into specific teams or areas to reduce the risks of cross infection by reducing the number of staff they had direct contact with. Opportunities had been missed to ensure risks were minimised in this area. This meant that staff were mixing with different staff members and people. This did not offer assurance that the provider was managing potential infection transmission risks effectively.

In December 2020 a new provider took over the service, people and staff felt there was a lack of communication with the new provider and felt unsettled with the changes. People felt the staff supporting them were kind and caring, although found some of the office staff not to be professional.

The provider did not have a robust quality assurance system in place which meant that where improvements were needed these were not identified and actioned. For example, people did not always receive their full support hours commissioned to them and people spoke about how staff were late to their support. This had not been picked up by the management team. Following the inspection, the provider spoke about a new quality assurance system they were planning on putting into place.

People told us they were involved in their care and staff listened to how they wanted their support to be given. However, there were occasions where people had contacted the management team to ask for changes to be made to their care and this was not always actioned promptly.

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 21 November 2019).

Why we inspected

We received concerns in relation to the management of medicines, safeguarding and the working culture. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

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 will continue to monitor the service to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to potential safeguarding concerns not being reported and investigated promptly and assurance systems failing to identify improvements needed in the service.

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

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.