Augusta Care Limited

Augusta Care Limited is a domiciliary care agency. It provides personal care to people living in their own homes and flats and supported living houses; it provides a service to older adults and younger adults.

This service provides personal care and support to some people living in supported living settings so that they can live as independently as possible. People's care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for supported living; this inspection looked at people's personal care and support.

At the time of the inspection personal care was being provided to 72 people. Not everyone using Augusta Care Limited receives the regulated activity; CQC 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.

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

People felt safe using the service and staff understood what their responsibilities were in relation to keeping people safe. One person said, “It’s fine. I love it here.” People had risks associated with their health and wellbeing, assessed and managed to ensure they received personal care and support safely. Staff administered people's medicines safely and prevented people from the risk of cross infection. The service worked in partnership with people, relatives and other agencies to support people's good health and well-being and provide consistent care.

People and their relatives spoke positively of the service and had opportunities to provide feedback and action was taken to address issues which were raised. A person said, "I have no complaints but know how to do that. I wouldn't be worried." Systems were in place to assess and monitor the quality and delivery of care to people. The nominated individual and manager were committed to providing good care to support people to achieve the best possible outcomes.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. One person said, “I go to the shops with staff. I do my own washing, make food, prepare a sandwich with staff watching.” Another person told us, “I’m free to go out when I want. I choose what I do.” Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support: The support provided by staff focused on ensuring people had choice, control and were encouraged to be as independent as possible.

Right care: People were treated as individuals and the support provided by staff promoted their privacy, dignity and human rights. Staff understood their responsibilities to respect people's human rights, including their right to privacy, confidentiality and to promote their independence.

Right culture: The registered manager, and support staff, all displayed values which prioritised supporting people to live confident, inclusive and empowered lives.

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 good (published 10 April 2018).

Why we inspected

The inspection was prompted in part due to concerns received about the management of incidents and staffing levels. A decision was made for us to inspect and examine those risks.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Augusta Care Company on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

This service provides personal care and support to people living in 42 supported living settings so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Not everyone using Augusta Care Limited receives the regulated activity; CQC 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.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion or independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

This announced inspection took place on 12 and 16 March 2018. This was the first inspection of this service since their CQC registration changed in 30 September 2016. There were 73 people, who live with a learning disability and who may also have mental and physical health needs, receiving the regulated activity of personal care at the time of this inspection.

The service had a registered manager. 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.

Staff had an understanding of the Mental Capacity Act 2005 (MCA). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff knew how and where to report any suspicions of harm and poor care practice.

People were assisted to take their medication as prescribed.

Processes were in place and followed by staff members to make sure that infection prevention and control was promoted and the risk of cross contamination was reduced as far as possible when supporting people.

Staff assisted people in a caring, patient and respectful way. People’s dignity and privacy was promoted and maintained by the staff members supporting them.

People, their relatives, and advocates were given the opportunity where appropriate to be involved in the setting up and review of people’s individual support and care plans. People were supported by staff to have enough to eat and drink.

People were assisted to access a range of external health care professionals and were supported by staff to maintain their health and well-being. Staff and external health care professionals, would, when required, support people at the end of their life, to have a comfortable and as dignified a death as possible.

People had individualised care and support plans in situ which documented their needs. These plans informed staff on how a person would like their care and support to be given, and how it was to be given in line with external health and social care professional guidance. However, some people’s care, support plans and risk assessments lacked detailed information as guidance for staff on how to mitigate people’s known risks.

There were enough staff to meet people’s individual care and support needs. Individual risks to people were identified and monitored by staff. Plans were put into place as guidance to staff to minimise people’s risks as far as possible to allow them to live as safe and independent a life as practicable.

Accident and incidents that occurred at the service were recorded. Learning from these incidents were communicated to staff and reviewed as part of the on-going quality monitoring of the service. This was to reduce the risk of recurrence and drive improvements forward.

There was a recruitment process in place and staff were only employed within the service after all essential checks had been suitably completed. Staff were trained to be able to provide care which met people’s individual needs. The standard of staff members’ work performance was reviewed through competency checks, supervisions and appraisals.

Compliments about the care and support provided had been received. Complaints received were investigated and resolved to the complainant’s satisfaction where possible.

The registered manager used innovative ways to involve people in the running of the service. This included a service user forum to discuss ideas and listen to external guest speakers and to help with the monitoring of the service.

The registered manager sought feedback about the quality of the service provided from people, relatives, staff and other stakeholders. There was an on-going quality monitoring process in place to identify areas of improvement needed within the service. An overview of this information was also shared with the organisations board of directors by the registered manager to make sure organisational oversight was in place.

The provider’s records showed that some incidents that the provider was legally obliged to notify the CQC of had not been submitted in a timely manner.

Further information is in the detailed findings below.