Aniis Care

Aniis Care is a domiciliary care agency. It provides personal care to mostly older people living in their own homes in the Surrey area. Some people were living with dementia or with physical disabilities. At the time of our inspection the service was providing care to 8 people.

People’s experience of using this service and what we found

People and relatives told us they felt safe. People had care and risk management plans in place, but the provider had not made sure these were always up to date and sufficiently detailed about how people should be supported. Some people’s plans did not always record how staff were to meet people's communication needs. There was a risk that people might receive inconsistent care or a new member of staff would not know how to care for people appropriately.

The provider had systems in place to monitor the quality of the service and make improvements. However, while there had been some improvements since our last inspection, these systems had not enabled the provider to identify and address the issues we found.

Staff supported people to receive their medicines as prescribed and medicines were managed appropriately. There were systems in place to help protect people from abuse and to investigate and learn when things went wrong.

The provider's recruitment processes helped to make sure they only employed suitable staff. People were usually visited by the same staff who they liked and knew their needs and how they liked to be supported.

Staff treated people with dignity and respect. People found staff kind and caring.

People and staff could give feedback about the service. People and their relatives knew how to raise any issues and found staff approachable. The service worked in partnership with other services to provide people with joined up care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 21 July 2022) and there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. We also met with the provider to discuss how they will make changes to ensure they improved their rating to at least good. We had also made a recommendation in 2021 that the provider consider current guidance on reviewing and updating people's care plans. At this inspection we found the provider had not acted sufficiently on this recommendation to make improvements. We found the provider had met some breaches, but there were two breaches of regulations and the service remains rated requires improvement. This service has been rated requires improvement for the last 4 consecutive inspections.

Why we inspected

We carried out an unannounced inspection of this service on 20 May 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, medicines support, recruitment, and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Caring, Responsive and Well-led which contain those requirements.

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 remained requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Aniis Care on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to personalised care and good governance. You can see what action we have taken at the end of this report.

Follow up

We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Aniis Care is a domiciliary care agency. It provides personal care to mostly older people living in their own homes in the Surrey area. Some people were living with dementia or with physical disabilities. At the time of our inspection the service was providing care to 21 people.

People’s experience of using this service and what we found

People and relatives told us they felt people were safe. However, the provider had not always assessed risks to people’s or staff members’ health and well-being or done all that was reasonably practicable to reduce those risks.

We received mixed feedback from people and their relatives. Some people spoke positively about their care experiences, while others said their care visits felt rushed and they had not always experienced a caring attitude from staff.

The provider had not consistently followed safe recruitment processes to help make sure they only employed suitable staff. Medicines support was not always managed safely. The provider did not always manage records about the service and people’s care appropriately.

There were arrangements in place for preventing and controlling infection, but the provider had not implemented these in line with national guidance.

There were some quality monitoring systems in place, but these had not always been effective as they had not enabled the provider to identify and address the issues we found.

Staff told us they felt supported by managers who were always available to them. The provider worked with other agencies to provide people with joined up care.

Rating at last inspection and update

The last rating for this service was requires improvement (published 20 April 2021).

At our last inspection we found a breach in relation to having effective systems in place to monitor and improve the quality of the service. The provider completed an action plan after the last inspection to tell us what they would do and by when to improve.

At this inspection, we found the provider remained in breach of regulations. At our last inspection we recommended that the provider consider current guidance on reviewing and updating people's care and risk management plans so as to assesses and support people to manage risks to their safety and well-being. At this inspection we found the provider had not acted sufficiently on this recommendation to make improvements.

Why we inspected

We received concerns in relation to the management of people’s care visits. As a result, we undertook a focused inspection to review the key questions of Safe and Well-led. We then widened the inspection to include the key question of Caring based on the evidence we found. 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 not changed following 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 Aniis Care on our website at www.cqc.org.uk

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed. We have found breaches in relation to safe care and treatment, medicines support, recruitment, and good governance.

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

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Aniis Care is a domiciliary care agency. It provides personal care to mostly older people living in their own homes in the Surrey area. It also supports some adults who are living with dementia and adults who have physical disabilities. At the time of our inspection the service was providing care to 18 people.

People’s experience of using this service and what we found

The provider had made some improvements to how the service was managed and the care people received. These included risk management plans to help minimise the risk of harm to people, personalised care plans, and working in line with the principles of the Mental Capacity Act 2005.

However, systems in place to monitor the quality of the service and make improvements when required had not always been effective. Some people’s care plans had not been updated to provide personalised information about their preferences for how they liked to be supported. Some people’s plans did not always record how staff were to meet people's communication needs or discussions regarding their end of life care wishes.

People told us they felt safe. People and relatives felt staff were caring and treated them with dignity and respect. People said staff respected their privacy and promoted their independence.

People were supported to maintain their health and access healthcare services. Staff worked with other agencies to provide people with joined up care. People received their medicines as prescribed. There were arrangements in place for preventing and controlling infection.

There were systems and processes in place to protect people from the risk of harm. The provider recruited staff using safe recruitment processes.

Staff received training, periodic supervision and regular support sessions with their managers. Staff told us they felt supported in their roles by the provider.

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.

We have made recommendations about people’s risk management and care plans.

For more details, please see the full report which is on the Care Quality Commission website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 14 February 2020) and there were multiple breaches of regulation. 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 that while some improvements had been made, other improvements were still required and the provider was still in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified a breach in relation to having effective systems in place to monitor and improve the quality 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.

Aniis Care is a domiciliary care agency. It provides personal care to mostly older people living in their own homes in the Surrey area. It also supports some adults who are living with dementia and adults who have physical disabilities. At the time of our inspection the service was providing care to 35 people.

People’s experience of using this service and what we found

People told us they felt safe. However, the provider had not always assessed risks to people’s health and well-being or done all that was reasonably practicable to reduce those risks.

The provider had not always recorded and responded appropriately to incidents that may affect people’s well-being. The provider had not always operated effective systems and processes to prevent people from experiencing a risk of abuse or harm. Some people had experienced late care visits. The provider had worked to address this with people when this had been reported to them. However, the provider did not have systems in place to monitor staff timeliness so they could be more proactive rather reactive to people’s concerns. We have made a recommendation about the systems and management of staff timeliness.

We received mixed feedback about the care people received. Most relatives said care staff were caring and treated people with dignity and respect.

People's care plans set out the care tasks they required help with, but these required more detail about how staff were to support people. Plans did not provide personalised information about people and their preferences for how they liked to be supported. The provider did not always record how staff were to meet people’s communication needs or people’s end of life care wishes.

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

There were systems in place to monitor the quality of the service and recognise when improvements were required. These were not sufficiently robust to have identified the issues we found at this inspection.

People knew how to make a complaint or raise a concern and the provider responded to these in a timely manner.

Staff received induction, training and periodic supervision. Staff found the managers approachable and told us they felt supported.

Adult social care professionals told us managers were responsive to and worked in partnerships with statutory agencies to meet people’s needs.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last

This service was registered with us on 27/11/2017 but did not start providing care at that time. The provider started providing care later and this is the first inspection of the service.

Why we inspected

This was a planned inspection based on the date the service was registered and when they started to provide a service.

Enforcement

We have identified breaches in relation to safe care and treatment, safeguarding people from the risk of abuse or harm, need for consent, person-centred care, and good governance.

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.