Background to this inspection
Updated
30 April 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team: The inspection was carried out by one inspector.
Service and service type:
A Plus Caring Ltd is a domiciliary (home care) care agency. It provides personal care to people living in their own houses and flats. A Plus Caring Ltd provides care and support to older people, younger adults, people living with dementia, people with a physical disability and people with sensory impairments. Not everyone using A Plus Caring Ltd receives the regulated activity of personal care. CQC only inspects the service being received by people provided with personal care, help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. There were 22 people receiving the regulated activity of personal care at the time of the inspection.
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. The registered manager was also the provider.
Notice of inspection :
We gave the service 48 hours’ notice of the inspection site visit because we needed to make sure that the registered manager would be in.
Inspection site visit activity started on 22 January 2019 and ended on 02 February 2019. It included visit to the office and telephone calls to people and relatives to get feedback about the service they received. We visited the office location on 22 January 2019 to see the registered manager and office staff; and to review care records and policies and procedures.
What we did:
Prior to this inspection we reviewed information we had received about the service. This included details about incidents the provider must notify us about, such as abuse. We also assessed the information we require providers to send us at least once annually 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 two people, four relatives, four staff members and the registered manager. We reviewed three care plans for people, three staff employment files, the providers policies and procedures and reviewed other records relating to the management of the service.
Updated
30 April 2019
About the service: A Plus Caring Ltd is a domiciliary (home care) care agency. It provides personal care to people living in their own houses and flats.
People’s experience of using this service:
People told us they felt the care and support they received was safe. Staff received training in safeguarding and they knew how to report their concerns internally and externally to safeguarding authorities.
People told us they could rely on staff coming to visit them, however they were not always sure what time staff would turn up. They told us recent staff`s departure meant that there were at times late visits as there was a shortage of staff. Relatives confirmed this and told us that there were occasional missed visits and staff were not always able to turn up at the agreed times.
Following the inspection, we received concerns from members of the public that the service was cancelling visits to people because they had not had enough staff to ensure staff`s absences could be covered on short notice.
Staff received training in some subjects considered mandatory by the provider, however their practical knowledge and competencies were not observed by the registered manager. Training for staff to understand how to care for people who lived with dementia was not provided.
Relatives of people who lived with dementia did not know if the support recorded in people`s care plan had been provided by staff. They told us at times they were not happy with the quality of the care provided.
People and relatives told us the registered manager had not always listened to their concerns when they raised issues with them. Concerns or complaints were not recorded or responded following the provider`s complaints policy.
People and relatives told us staff were kind and caring. People`s dignity and privacy was protected.
Care plans were developed when people started using the service, however risk assessments were not developed for each identified risk to people`s health and wellbeing.
People told us staff were adapting and were responsive to their needs and supporting them the way they wanted.
The service operated for just over a year and some of the provider`s policies and procedures needed further developing to ensure they were based on current legislation and best practice guidance.
The registered manager monitored the quality of the service through audits and feedback received from people and relatives, however there was no evidence that improvement to the service were implemented.
Rating at last inspection: This was the first inspection of the service since they registered with the Care Quality Commission on 20 December 2017.
Why we inspected: This was a planned inspection.
The overall rating for this service is ‘Inadequate’ and the service therefore is in ‘special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.
The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.
For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures
Following the inspection CQC reviewed the concerns and took appropriate action.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.