Archived: Anjel Direct (Recruitment) Solutions Ltd

Anjel Direct (Recruitment) Solutions Ltd is a domiciliary care service. It provides care to people living in their own homes. At the time of our inspection they were supporting 23 people.

Anjel Direct (Recruitment) Solutions supports younger and older people with a range of needs including physical disabilities, learning disabilities and dementia.

People’s experience of using this service

Risk assessments and care plans were not always present or completed correctly. Moving and handling risk assessments were not completed in detail. The service did not adequately assess people’s risks around medicines and instructions in care plans were unclear or misleading. This put people at increased risk of harm. The service had failed to make the required improvements in this area following the last inspection.

Staff were not always recruited safely. The service had failed to make the required improvements in this area following the last inspection.

People told us they usually had continuity of care from reliable staff. However, accurate timesheets were not being kept.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Consent had not always been sought in line with the regulations. The service had failed to make the required improvements in this area following the last inspection.

Most people were satisfied or pleased with the care they were receiving, and some spoke highly of individual care workers.

Staff were aware of the signs of abuse and knew how to report any concerns. People and their relatives told us they knew how to complain.

Staff told us the registered manager was supportive, and he spent a lot of time supporting people. However, being less present in the office meant that he was less effective in his oversight of the service.

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 (published 29 November 2018). The provider did not complete an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to keeping people safe, assessing and managing risk, gaining consent for care, assessing people's needs and the good governance of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and people with physical disabilities in the London Borough of Bexley. At the time of our inspection there were eight people using the service.

People told us that their care workers arrived on time and were reliable. The provider did not consistently use safer recruitment processes to ensure that staff were suitable for their roles. Care workers were aware of their responsibilities to safeguard people from abuse.

There were processes for assessing and managing risks to people using the service, but these were not effective in managing the risk of pressure sores. Where people were supported with their medicines, care plans and logs of care were not consistent on the level of support people required. There was insufficient recording of what medicines people had been supported to take and when, and there were not effective audits carried out of this.

Care workers received induction and training. Care workers did not always receive the mandatory training. Some, but not all, mandatory trainings were booked to take place. Care workers told us that managers checked that they provided a good service, but there were not records maintained of this. Managers did not keep records of the formal supervision of care workers.

People had not signed their care plans to indicate consent to care. Where people were not able to consent to care there were not measures in place to assess people’s decision making capacity and to evidence that care was provided in their best interests.

People’s care needs were assessed in detail. This was used to plan people’s care in order to meet these. Care plans were person centred and contained information on people’s preferences for their care. There was information on how best to communicate with people and what may cause people to become anxious and upset. Plans captured people’s health care needs and how they impacted on their wellbeing and daily living skills. Records of care were brief and frequently incomplete and did not demonstrate that people received care in line with their plans. Managers did not have audit systems in place which would allow record keeping to improve.

People told us that they received support which was flexible and met their needs. People consistently received care from the same care workers and knew how to complain if something needed to improve.

We found breaches of regulations relating to safe care and treatment, the management of medicines, staff recruitment, training and supervision, consent to care and good governance. You can see what action we told the provider to take at the back of the full version of this report.