All About Care (South West) Limited

Updated 29 July 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 and 1 Expert by Experience. An Expert by Experience 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 and specialist housing.

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 not a registered manager in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 3 July 2023 and ended on 13 July 2023. We visited the location’s office/service on 3 July 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 9 people who used the service and 8 relatives about their experience of the care provided. We spoke with or received email feedback from 11 members of staff including the director, the nominated individual, the manager, senior workers, and care workers. We reviewed a range of records. This included 6 people's care records and 3 medicine administration records. We looked at 5 staff files in relation to recruitment and staff supervision and a variety of records relating to the management of the service including governance audits, policies and procedures were reviewed.

The nominated individual is responsible for supervising the management of the service on behalf of the provider.

Updated 29 July 2023

About the service

All About Care (South West) Limited is a domiciliary care agency providing personal care. The service provides support to people who live in their own homes. At the time of our inspection there were 33 people using the service.

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

A new management team acquired the service in May 2023 and were open and honest throughout the inspection. When the service was taken over the new management team discovered staff had not received adequate training, risk assessments, care plans and mental capacity assessments were not always in place and there were no effective governance systems to ensure oversight and the safe care and treatment of people using the service.

Whilst the new management team had made some improvements by the time of our inspection, they acknowledged there was a lot more work to do to ensure people were receiving safe, effective, and responsive care. At our inspection we found not all incidents had been reported by staff for appropriate actions to be taken to ensure people were kept safe. People had not always been assessed for any risks to their health, safety and wellbeing for instructions to be given to staff to reduce the likelihood of harm. Medicines had not always been managed safely and people had not always received their medicines as prescribed.

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; the policies and systems in the service did not support this practice. Staff had not received effective training in the mental capacity act and people did not always have mental capacity assessments and best interest decisions in place in accordance with the mental capacity act.

We have made a recommendation about regular staff supervisions and appraisals.

Care plans did not always reflect the needs of the people staff supported and had not been regularly reviewed to ensure the information was kept up to date.

We found systems and processes were either not in place or robust enough to identify areas of improvements and this had led to people being placed at risk of harm.

People told us they felt safe and felt well cared for by staff who were kind and caring. One person told us, “They have all been very nice, they make me feel safe.” There were enough staff to meet people’s needs, staff had been recruited safely into the service, staff had access to personal protective equipment (PPE).

Pre-assessments had been completed for every person who started using the service from May 2023. Staff had been provided with an up-to-date effective training programme due to be completed in July 2023. People were assisted with ready meals and prompted to drink to prevent dehydration. People were supported to access healthcare professionals when they needed them.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

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 21 March 2018).

Why we inspected

The inspection was prompted in part due to concerns received about staff recruitment, staff training and lack of risk assessments. A decision was made for us to inspect and examine those risks.

You can see what action we have asked the provider to take at the end of this full report.

The provider, who acquired the service in May 2023 along with the new management team were responsive to the concerns found and started to implement systems and process to keep people safe.

Enforcement and Recommendations

We have identified breaches in relation to seeking consent from people who use the service, the safe care and treatment of people using the service and good governance of the service.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.