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Archived: Apex Health + Social Care - Haydock

Unit 5, The Parks, Haydock, Cheshire, WA12 0JQ 0845 600 3041

Provided and run by:
PHIRST Group Limited

All Inspections

24, 30 April 2014

During a routine inspection

This unannounced inspection involved following up on two areas of non-compliance identified at our previous inspection in January 2014. The inspection also set out to answer our five questions:

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

Below is a summary of what we found. The summary is based on three visits to people in their own homes, discussions with staff and looking at records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

The service was safe because systems were in place to manage risks. Recruitment checks were in place to ensure staff were suitable to undertake their roles. Medication was being managed appropriately. Medication recording had improved since the last inspection; however we did note some gaps.

Is the service effective?

The service was effective as staff ensured people's care and support needs were met. Staff had received appropriate training and were supported within their roles.

Is the service caring?

The service was caring because staff had the right approach and people were positive about the care and support given. People had their privacy and dignity respected.

Is the service responsive?

The service was responsive, as people had their care and support needs assessed and kept under review and staff responded quickly when people's needs changed. There was a complaints system and people had the information they needed to know how to make a complaint.

Is the service well-led?

The service was well led. However, a Registered Manager was not in place at the time of our inspection. We informed the manager of the importance of being registered with the Care Quality Commission. They agreed to submit the application as soon as they were able to do so.

There was a system in place to quality assure the care being provided.

16, 17 January 2014

During an inspection looking at part of the service

We inspected Apex to determine whether the provider had complied with warning notices for quality assurance and records, as well as compliance actions for medication and complaints made at the previous inspection visit in August 2013.

At the last inspection we found the provider did not have a satisfactory system in place to regularly assess and monitor the quality of the service or manage risks to people in carrying on/managing the regulated activity. We found this concern had been addressed. We also found improvements had been made to the complaints system.

At the last inspection we found people were not protected from the risks of unsafe and inappropriate care and treatment because accurate and appropriate records were not maintained. We found this concern had been addressed. All care plans had been rewritten based on people's identified needs onto the new care plan documentation.

However, as previously found, appropriate arrangements were not in place for medicines record keeping. In addition, we found one person had received inappropriate care and support in relation to their moving and handling needs, which put their safety at risk.

19, 20, 27 August 2013

During an inspection looking at part of the service

We inspected the agency to determine whether the provider had complied with compliance actions made at the previous visit in April 2013. We found good progress had been made in addressing concerns about the management of safeguarding issues. The agency had invested in safeguarding training and safeguarding concerns were now routinely being referred appropriately. Previous concerns about staffing, particularly about care workers having the right skills to provide care had been addressed. The agency had made improvements to its record keeping systems. However, further work was required to ensure an accurate record was maintained for each person receiving care and support.

Quality assurance systems in operation at the agency continued to fall short of the relevant requirements. During the inspection, we identified continuing concerns with regard to quality of care planning, medication management, handling of complaints and quality assurance. All the actions within the action plan had not been met.

The people and / or their relatives we spoke with were satisfied with their regular carers and told us that communication with the central office of the agency was improving. Overall, the ten responses received from the survey were positive. One person said, 'Very good care always. Carers are friendly and helpful. If at any time a mistake is made it is dealt with satisfactorily.'

4, 5 April 2013

During a routine inspection

We visited four people who were receiving care and support from Apex in their own home. One person was able to speak with us directly. We were unable to speak with the other three people we visited but were able to speak to their relatives. The people we spoke with told us about their views and experiences of the service Apex provided. People told us they were satisfied with the care and support provided to them or their relative. One person said 'They [the staff] are very good.' They also told us that the care workers had built a positive rapport with their relative. One family told us care workers had been responsive to their relative's cultural needs.

All the people we spoke with told us they valued the same care workers attending regularly to provide consistent support. People said that when the regular care workers attended the care provided was excellent. One person told us their regular carers were very supportive and treated them with dignity and respect. They also said they found their regular carers to be flexible in their approach and willing to help. However, people told us that on occasions their regular carers didn't attend and in these instances sometimes the care was not as good as they didn't have an understanding of their needs. People said care workers usually came on time and stayed for the full length of their allocated call time.

6 March 2013

During an inspection in response to concerns

We spoke with managers about the support provided with people's medication and looked at how this was detailed within people's service user plans. The support proved to clients was confirmed with two members of staff engaged in providing this care.

We found that although staff were clear about the support they were providing with medicines, the information within support plans did not make direct reference back to the agency's policy. This meant that on occasion staff were uncertain about the level of accountability and hence the level of medicines record keeping required.

20 June 2012

During a themed inspection looking at Domiciliary Care Services

We carried out a themed inspection looking at domiciliary care services. We asked people to tell us what it was like to receive services from this home care agency as part of a targeted inspection programme of domiciliary care agencies with particular regard to how people's dignity was upheld and how they can make choices about their care. The inspection team was led by a CQC inspector and joined by an Expert by Experience who has personal experience of using or caring for someone who uses this type of service.

We carried out 20 telephone interviews and spoke with four people who use services and four relatives within their own homes to gain views about the service. We contacted the local authority that has a contract with the agency, and the local safeguarding adult's team. We also spoke with the manager and three staff who work for the agency. We received 13 postal surveys.

People told us that Apex Health and Social Care - Haydock provided good quality care and offered a reliable service. People spoke positively about their care workers and felt they fully supported their care needs. People also said that their care workers spoke with them in a calm and respectful way.

People said that their care was personalised to their needs and their preferred names were used at all times. They also said their care package was reviewed on a regular basis with them and some people said that they had completed a questionnaire about the support they had received. Most people said that they had a choice about the care and support that they were to receive from the agency. Others did not have the capacity to do this but their families did it for them. Most of the people were and are involved about the way their care is given to them. If any one had a complaint about their support they all have numbers that they can ring and names of key people. They said that most of the time their views are listened to by the management of the agency.

People felt that staff were well trained and understood their needs. They said they felt safe and if they had concerns they would speak with a family member, friend or somebody from the office. People said that the care and support is flexible and can be adjusted to meet people's individual needs.

Staff commented that they enjoyed their work and that the support they get from the staff and management team is good. They also commented "The agency is good to work for" and "seeing people improve is the best part of my job."