Archived: Angels Community Homecare Services

This announced inspection took place on 10 and 16 June 2015. The provider had a short amount of notice that an inspection would take place so we could ensure staff would be available to answer any questions we had or provide information that we needed.

Angels Community Homecare Services is registered to deliver personal care. They provide care to people who live in their own homes within the community. At the time of our inspection 21 people received personal care from the provider.

At our last inspection in January 2015 the provider was not meeting the regulations which related to safeguarding people who used the service, requirements relating to workers and assessing and monitoring the quality of service provision. Evidence that we gathered during this, our most recent inspection, showed that some improvements had been made but further improvements were needed.

The registered manager had left the service in December 2014. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The provider had appointed a new manager in May 2015 who told us that they were in the process of applying for registration with us.

People we spoke with told us that they felt safe. We saw that there were systems in place to protect people from the risk of abuse, including safe recruitment processes.

We found that medicines management within the service were safe; however recording of the timing of when people were supported to take their medicines was inconsistent.

There were a suitable amount of staff available to meet people’s needs in a timely manner, with the appropriate skills, experience and training. Staff told us that they were being provided with the training that they required.

Structures for supervision allowing staff to understand their roles and responsibilities were in place.

Systems were not always effective in demonstrating people’s level of mental capacity and/or any potential risks for staff to consider. The manager showed us a new system that was currently being implemented to improve and to develop more consistency in care records for staff to refer to.

Staff maintained people’s privacy and dignity whilst encouraging them to remain as independent as possible. People and their relatives told us they were happy with the way the service communicated with them.

Feedback was sought from people and their relatives. The manager told us that on receipt of any negative comments, they had contacted the person and resolved any issues they raised; however they were unable to demonstrate this to us as they had not appropriately documented, analysed or outlined any plans for improvements as a result.

Care was planned with people and their relative’s involvement; care plans were not always detailed enough in respect of people’s disabilities and/or failed to outline their medical conditions clearly for staff to be aware of.

Information was provided for people about how to make a complaint. People and their relatives told us they felt confident that any concerns or complaints they made would be dealt with appropriately.

Staff told us they felt supported by the manager and provider. Systems were in place to regularly to develop and involve staff through supervision and staff meetings.

We found that the provider had made improvements to how they monitored and quality assured the service provided. However, we identified a number of areas that required improvement to ensure these systems were more robust.

Our inspection took place on 12 and 14 January 2015. The inspection was unannounced.

The provider is registered to deliver personal care. They provide care to people who live in their own homes within the community. At the time of our inspection 29 people received personal care from the provider.

At our last inspection in May 2014 the provider was not meeting Regulation 10 which related to the assessing and quality monitoring of the service. Evidence that we gathered during this, our most recent inspection, showed that no improvement had been made. We found that the service was not well led and was not being run in the best interests of the people who used it.

The registered manager had left the service in December 2014. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The provider had appointed a new manager who told us that they were in the process of applying for registration with us.

Some people and their relatives that we spoke with told us that the service was good. Other’s told us that it was not good in that there was a lack of staff, a lack of communication for example, people did not always know which staff member was to provide their care that day, some care calls were late and others were missed completely.

The provider was not up-to-date with what was legally required of them regarding for example, the safe recruitment of staff and medicine management safety. We found that the recruitment processes placed people at high risk of harm by them being cared for by staff that had not been appropriately checked or confirmed as suitable to care and support them. We also found that medicines were not managed to a safe standard. Medicine recording did not confirm the actual medicines that were given or how many medicines the staff had supported people to take. We found that some care calls were late or had been missed completely. The poor performance of the provider in all those areas resulted in people being placed at risk of harm, being neglected and having some of their care needs omitted.

The provider told us that they had not carried out any audits. They told us that they had trusted the previous registered manager and had not undertaken any checks on the work that manager had done.

Low staffing levels placed people at risk of them not receiving the care and support they needed or not receiving their care and support at the right time.

We found that a complaints procedure was available for people to use. However, although we asked the provider a three times, they did not show us the complaint log in order for us to determine if staff had followed the complaints procedure. This meant that people and their relatives could not be assured that any dissatisfaction would be looked into or dealt with effectively.

Staff told us that were not adequately supported in their job roles. The provider confirmed that staff support mechanisms were lacking which included formal one to one supervision sessions for staff and staff meetings.

People told us that they had not been asked to complete feedback surveys, for example, about their experiences of the care that was provided or the overall quality of the service that they received.

People we spoke with told us that they felt safe. We saw that there were systems in place to protect people from the risk of abuse.

People who used the service described the staff as being nice and kind and our observations showed that they were. We saw that interactions between staff and one person who used the service were positive in that staff were respectful, polite and helpful to that person.

Staff told us that they were being provided with the training that they required. This would ensure that they had the skills and knowledge to provide safe and appropriate support to the people who used the service.

You can see what action we told the provider to take at the back of the full version of the report.