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Affinia Healthcare Requires improvement

This service was previously registered at a different address - see old profile

We are carrying out a review of quality at Affinia Healthcare. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 17 August 2018

This announced inspection took place on 10 July 2018. At the last inspection in October 2017, the service was rated as Inadequate. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the service. We did receive a comprehensive action plan within the time allocated to them. This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

We asked the provider to take action to make improvements in staff training, medicine management, risks to people, care planning, about how specific decisions of people who may lack capacity had been made and how safeguarding processes were managed. During this visit, we found some of the actions had been completed. However, further improvements were needed regarding how risks to people were assessed and information about how to communicate with people.

Affinia Healthcare is a domiciliary care agency that provides personal care to people living in their own homes and some living in supported living in the London Borough of Havering. At the time of our service, there were 13 people using the service, three of whom were receiving personal care in a supported living set up.

There was no registered manager in place as the registered provider was in day to day charge 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.

We found that the risks associated with people’s support were not always fully assessed, which could have an impact on the safety of people.

Care plans did not mention people’s ability to communicate and how staff should communicate with people. Records showed that some people required information through a communication passport and in an easy read format. This was not available at our inspection.

The service had an efficient system to manage accidents and incidents and learn from them so they were less likely to happen again. The provider had safeguarding policies and procedures in place. Staff had received training about how to safeguard people from abuse.

Systems were in place to make sure people received their medicines safely and for the monitoring and prevention of infection.

The provider employed enough staff to meet the needs of people. There was a recruitment system in place that helped the provider make safer recruitment decisions when employing new staff.

Staff had the knowledge and skills to care for people effectively and responded promptly to their needs. They had a structured induction at the beginning of their employment and received regular supervision and an annual appraisal.

Staff demonstrated a good understanding of the requirements of the Mental Capacity Act 2005. The consent of people was sought appropriately. Referrals were made to health care professionals for additional support or guidance if people’s health needs changed.

An initial assessment of people was carried out before they started using the service. People or their representatives had been involved in writing their care plans. People received care and support in accordance with their preferences, interests and diverse needs.

Staff had a good knowledge and understanding of people's needs. People who required support with meals were provided with food and drinks which met their nutritional needs. People’s privacy and dignity were respected.

People were

Inspection areas

Safe

Requires improvement

Updated 17 August 2018

The service was not always safe. Not all risks associated with people’s care and support were assessed, and measures were not put in place to ensure staff supported people safely.

People were protected against the risk of abuse. Staff understood their role in safeguarding people and how to raise concerns about people’s safety.

The provider had effective recruitment and selection processes in place. Sufficient staff were available to meet people’s needs.

People who used the service received their medicines as prescribed by their doctors.

Systems were in place for the monitoring and prevention of infection.

Effective

Good

Updated 17 August 2018

The service was effective. People’s needs were assessed before they started to use the service.

Staff understood and acted in line with the principles of the Mental Capacity Act 2005. Where people did not have the capacity to consent, the staff acted in accordance with legal requirements.

People were supported to maintain good health and to access healthcare services when they needed them.

People’s dietary needs were taken into account and their nutritional needs were monitored appropriately.

Caring

Good

Updated 17 August 2018

The service was caring. People were treated with compassion by staff who knew their needs and preferences and their privacy and dignity were maintained.

Staff demonstrated a good knowledge about people they were supporting. People were able to make choices about their care and their views were taken into account.

People were supported to be as independent as possible and they had access to advocacy services to represent them where applicable.

Responsive

Requires improvement

Updated 17 August 2018

The service was not always responsive. Care plans did not always mention people’s ability to communicate and how staff should communicate with people.

People were involved in the planning of their care and had access to activities to protect them from social isolation.

People and their representatives knew how to make a complaint and their views were listened to and acted upon. Where concerns had been raised the provider had taken appropriate action to resolve the issues.

Well-led

Requires improvement

Updated 17 August 2018

The service was not always well led. There were systems in place to monitor the quality of the service and identify shortfalls. However, we found where improvements were identified during care plans audits, the actions to be taken were not always clear.

People and their relatives spoke positively about the way the service was managed. The provider had a positive culture and was committed to delivering effective care for people.

Staff were clear about what were expected from them. They had access to policies and procedures to inform and guide them in their roles.

There was a system in place to check if people were satisfied with the service provided. The provider welcomed suggestions on how to improve the service.