Background to this inspection
Updated
25 October 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 05, 20 and 21 September 2018. We gave the service 48 hours’ notice of the inspection because we needed to ensure the registered manager would be available.
The inspection was undertaken by one inspector.
Prior to this inspection we reviewed information we held about the provider. We reviewed a copy of the Provider Information Return (PIR) submitted to us. This is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed statutory notifications sent to us by the registered provider. Statutory notifications include information about important events which the provider is required to send us. We reviewed a copy of the providers action plan, which was a document that set out how, and by when they would make the required improvements found at the last inspection.
During our inspection, we visited the office to look at records and talk with the registered manager and returned on 20 September 2018 to speak with staff. We looked at the care records for two people who used the service and records relating to the management and running of the service. These included three staff recruitment files, care plans relating to peoples care and support needs and records relating to the management of the service.
Updated
25 October 2018
This inspection took place on 05, 20 and 21 September 2018 and was announced. At our previous inspection on 20 September 2017 we found the service required improvement. This was because risks were not always assessed and known by staff, incidents were not always documented and reviewed and staff had not been recruited following a robust recruitment procedure. Staff were not supported to develop in their role, and people did not all feel care was provided in a manner that suited them. The service was incorrectly registered at a different address. At this inspection we found the provider had made improvements, however, they were still developing their governance and management systems.
The service is a domiciliary care agency. Avocet Health Care provides support to people who require support with daily tasks and personal care in their own homes. Not everyone using the service receives the regulated activity of personal care. CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.
At the time of our inspection, there were five people receiving personal care from the service.
The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered care homes, 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.
People and relatives told us they felt safe when receiving care and support from the service. Staff were knowledgeable about the risks to people’s health and welfare and clearly described how they minimised the likelihood of occurrence. However, care records required further development to document robustly the actions required.
Staff had completed training in safeguarding of adults and were aware of their responsibilities for keeping people safe, and reporting incidents of abuse. Incidents and accidents were recorded, reviewed and lessons learnt to improve the service.
People were supported by sufficient numbers of staff who were appropriately checked to ensure they were suitable to work at the service. People’s medicines were administered as the prescriber intended, however staff were not clear on when they were required to administer these. People were protected from the risk of infection when care was provided as staff followed clear guidance.
Care plans were based on the assessed needs of people, which meant that people received personalised care and support. People felt staff were sufficiently trained to support them effectively and staff felt supported by the registered manager. Staff were provided with regular supervision sessions, however, they had not been able to further develop their skills or knowledge.
Staff understood the principles of the Mental Capacity Act 2005 (MCA) and people’s capacity to make decisions was assessed when required. They encouraged and promoted people's rights to make their own decisions about their care.
Staff supported people with nutrition and hydration, when needed.
Staff were kind, caring and passionate about their roles. Staff maintained people's privacy and treated them with respect and dignity. People told us they had good support, from staff who provided them with care that met their needs and preferences. People told us the care they received responded to their needs and felt valued by the staff who cared for them. People told us that staff supported them to maintain links in their community, show and interest in them and encourage them to participate in activities.
There was a clear complaints procedure in place. People knew how to make a complaint if they had concerns.
People and staff felt the service was well led. The views of people were sought about the quality of care provided, however, the registered manager did not formally seek the views of their staff or relatives. Since the previous inspection, improvements had been made in some areas, however, we found progress in achieving these required actions was not within a reasonable time frame and required further improvement. We found that although the registered manager had carried out their own review of the quality of care within the service, this did not address some of the areas we identified and brought to their attention.