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Availl (Norwich) Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 6 February 2019

Availl (Norwich) is a domiciliary care agency. It provides a service to a range of people including older adults, adults who have learning disabilities, physical disabilities and mental health needs.

A domiciliary care agency provides personal care to people living in the community. CQC does not regulate premises used for domiciliary care because people receive this service in their own homes. CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. At the time of our comprehensive inspection there were 15 people receiving a personal care service we regulate.

There was a registered manager in post at the time of our inspection. The registered manager was also the provider of the service having purchased a franchise for the branch from the wider Availl business. The registered manager was also supported by a branch manager who took on the day to day management of the service. A registered manager is a person who has registered with the Care Quality Commission 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. For the purposes of this report we will refer to the provider as the registered manager.

At our last inspection in June 2017 we rated the service ‘Requires Improvement’ overall. At that inspection we found several breaches of the Health and Social Care Act 2008. We found that people did not have thorough care assessments in place. The risks which people faced had not been fully explored and care plans did not guide staff about how to meet people's needs in a safe way. People’s care assessments and reviews were not always person centred.

At that inspection we were also concerned that the competency of staff was not being checked on a regular basis and staff did not receive the training they needed to support people effectively. At our last inspection we also found that some people did not receive their medicines safely because this need had not been identified in their assessments. Staff did also not recognise when systems were not in place to support people with their medicines. We also found that there were insufficient systems in place to monitor the quality of the care and service provided and audits were not taking place in relation to people's care records.

At this inspection we found that there were some improvements, however these were still on-going and not fully embedded or effective yet. Care planning was detailed however it did not cover specific healthcare needs or support needs that some people had. Some improvements had been made to the safe management of people’s medicines however there were some discrepancies between people’s MAR charts and their care plans.

The registered manager had increased the frequency of the checks being carried out of staff competency and was ensuring that regular checks of staff practice were now being made. Staff continued to receive training however they had mixed views in how effective they found this in the format in which it was delivered.

Some improvements had been made to the auditing of people’s care records. Audits were now in place; however, they were not wholly effective. The audits undertaken did not identify the concerns that we found with gaps in care records.

The rating for the service continues to be rated ‘Requires Improvement’. We also found a continued breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated activities) regulations 2014.

People and their relatives felt safe with the service they received. Staff were clear on how to recognise potential harm and how to safeguard people. There were sufficient staff available to visit people and provider their care. Recruitment practices were thorough and made sure new staff were suitable to work with peo

Inspection areas

Safe

Requires improvement

Updated 6 February 2019

The service was not always safe

Medication recording systems required improvements

There were a lack of risk assessments covering people�s specific needs.

There were sufficient staff employed to cover care calls

Safe and effective recruitment practices were followed to ensure that staff were suitable for the roles they performed.

Effective

Requires improvement

Updated 6 February 2019

The service was not always effective

Staff did not always find the training methods used by the provider effective.

Consent to care and treatment had not been sought in line with legislation and guidance for one person using the service.

People who received support with meals were happy with this aspect of their care.

Staff felt supported in their roles however they did not find the training they received effective.

Caring

Good

Updated 6 February 2019

The service was caring

People were supported by staff that were caring towards them.

People's privacy and dignity was maintained.

Responsive

Requires improvement

Updated 6 February 2019

The service was not always responsive

People�s care plans were not always reflective of their care and support needs.

People knew how to raise concerns and were confident these would be dealt with in a prompt and positive way.

Well-led

Requires improvement

Updated 6 February 2019

The service was not always well-led

Systems in place to audit the service were not wholly effective.

People who received support and staff were very positive about the registered manager and office staff.

There were systems in place to seek the feedback of people using the service.