Background to this inspection
Updated
9 March 2023
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 Health and Social Care Act 2008.
Inspection team
The inspection was carried out by 1 inspector. An assistant inspector rang people who used the service and their relatives following the inspection.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
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
We used information gathered as part of monitoring activity that took place on 22 August 2022 to help plan the inspection and inform our judgements. We also reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 4 people and 7 relatives over the telephone. We also spoke with 12 members of staff including the registered manager, the regional manager, the deputy manager, a care co-ordinator, field supervisor and care staff. We looked at 3 staff recruitment files, training records, a variety of audits and 6 care plans.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at audits and training records.
Updated
9 March 2023
About the service
Advance Healthcare (UK) Limited provides personal care and support to people living in their own home. The agency provides care and support for older people, adults with disabilities and people who live with dementia. At the time of our inspection visit, services were being delivered to 159 people.
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 wide social care provided.
People’s experience of using this service and what we found
Since the last inspection, the provider had taken on another company, staff and their service users. Not all staff felt well informed regarding the merger of the 2 companies and felt communication could be improved.
The provider’s audits had not identified areas for improvement that were found on inspection. People were supported by a group of staff who knew them well, but care records did not always hold the most up to date information regarding people and their care needs. Current systems in place to monitor call delivery times were not always effective, which resulted in some people experiencing early or short calls.
People felt safe when supported by staff in their own home and were supported by a consistent group of staff who had been safely recruited. People were supported by staff who followed the latest infection control guidance when providing care. Accidents and incidents were reported and acted on and analysed for any lessons to be learnt.
People were complimentary of the staff who supported them. Staff felt supported but said they would value face to face training rather than online training. Staff were aware of people’s nutritional needs and supported people to attend healthcare appointments. 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’s feedback of the service was being sought and this information was used alongside other audits to help drive 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 good (published 18 March 2020). Since this last rating was awarded the registered provider has moved premises. We have used the previous rating to inform our planning and decisions about the rating at this inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Advance Healthcare (UK) Limited 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.