Background to this inspection
Updated
24 July 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
This inspection was carried out by one inspector and an Expert by Experience (ExE). An ExE is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
Before the inspection the registered manager completed a Provider Information Return (PIR). We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We looked at the notifications we had received for this service. Notifications are information about important events the service is required to send us by law.
During the inspection
We spoke with the Nominated Individual and registered manager. We will refer to them in this report as the management team. We also spoke with the assistant manager and care staff. We looked at four people’s care records, and the last three months of all people’s associated medicine records. We looked at records of accidents, incidents, compliments and complaints received by the service.
We looked at audits and quality assurance reports completed by the management team. We looked at training records, recruitment records, staff supervision and appraisal records.
After the inspection
We asked or requested additional information. This included Apex Healthcare Services policies and procedures and feedback from staff and relatives.
Updated
24 July 2019
About the service
Apex Healthcare Services Ltd is a domiciliary care service (DCS). DCS provides support and personal care to people within their homes. This may include specific hours to help promote a person's independence and well-being. At the time of the inspection 49 people using the service were designated support with personal care. The service was predominantly catering for younger and older adults, with a varying level of personal care needs. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
The service had processes in place to ensure people were supported by suitable staff however they could not always evidence they had taken a full employment history of staff. This was being rectified by the management team. We made a recommendation that they familiarise themselves with the current regulations regarding recruitment.
People’s needs were assessed, planned and reviewed to ensure they received support that met their changing needs. Staff managed people’s risk assessments and care plans to ensure they were person-centred. A person’s record keeping needed to be further strengthened to evidence when actions had been taken. We made a recommendation that the service ensure all records are accurate and contemporaneous.
All accidents and incidents and medicines were recorded and reviewed by the management team.
The provider had an effective system to ensure that staff received appropriate training. The care certificate modules formed part of the induction training. All training the provider considered to be mandatory was up to date. Staff worked in partnership with professionals from health and social care to meet people’s needs. People’s files and care plans contained evidence of referrals.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People received support that was individualised to their personal needs. People's care plans placed their views and needs at the centre. Staff were knowledgeable about the choices and preferences of the people they provided care and support to. Complaints were managed robustly and in a timely way.
There were effective management systems in place, with a clear staffing structure. The service had formed good working relationships with partners, which included the local authority, social workers and district nurses. The management team had a clear and effective process for continuous learning and service improvement.
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 requires improvement (report published 30 June 2018) 13 April 2018.
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.