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Archived: Angels Community Homecare Services Requires improvement

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 24 August 2015

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.

Inspection areas

Safe

Requires improvement

Updated 24 August 2015

The service was not always safe.

We found medicines were provided in an effective manner; however, records completed by staff were inconsistent in quality and detail which could lead to potential omission or errors occurring.

Staff were knowledgeable and had received training about how to protect people from harm.

Risks for people in regard to their health and support needs were not consistently assessed; however staff were clear about how to reduce any potential risks to people through the support they provided.

Effective

Requires improvement

Updated 24 August 2015

The service was not always effective

Staff received regular training and had the appropriate level of knowledge and skills to meet people’s needs.

Staff understood how to effectively gain peoples consent when supporting them; however records did not consistently demonstrate how staff should act in the persons best interests when the person lacked capacity to provide informed consent.

People were supported to access specialist healthcare professional input from outside the service to meet their needs.

Caring

Good

Updated 24 August 2015

The service was caring.

People and their relatives were complimentary about the staff, support and communication they were provided with.

Comments we received from people and their relatives told us that staff respected people’s privacy and dignity when proving support to them in their homes.

Responsive

Requires improvement

Updated 24 August 2015

The service was not always responsive.

Care plans did not consistently give clear detailed information about people’s medical conditions or disabilities for staff to reference and be aware of.

Regular reviews of care provision were undertaken with people or their relatives, either by phone or face to face.

People and their relatives were provided with information about how to complain and told us if they had any concerns or issues they felt sure the manager would deal with them.

Well-led

Requires improvement

Updated 24 August 2015

The service was not always well-led.

People and their relatives all spoke highly about the approachability and impact of the new manager.

Staff received regular support and told us this was as an opportunity for them to discuss their development and progress.

Quality assurance systems needed to be more robust.