Background to this inspection
Updated
6 August 2019
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 Care Act 2014.
Inspection team
This inspection was completed by one inspector and an 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 and nursing support to adults or children living in their own houses, flats and specialist housing. 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.
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.
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. We also needed consent to speak to people using the service to be gathered.
What we did before inspection
We reviewed information we had received about the service since they registered as a provider. We sought feedback from the local NHS Continuing health care team and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with three people who used the service and 12 relatives about their experience of the care provided. We spoke with six members of care staff and the provider’s nominated individual, registered manager, and regional clinical lead. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included three people’s care records and medication records. We looked at four staff files in relation to recruitment, training and staff supervision. A variety of records relating to the management of the service, including quality assurance records, complaints and incident records, policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We spoke with three professionals who regularly work with the service.
Updated
6 August 2019
About the service
Apollo Healthcare Ltd is a domiciliary care agency specialising in providing personal care and assistance for people with complex healthcare needs living in their own homes. The East Anglian office of Apollo was supporting 27 people at the time of this inspection, including eight children, the majority of which was funded by NHS Continuing Health Care for 24/7 care. This support often included appropriately delegated healthcare tasks required to enable people to live in the community safely.
People’s experience of using this service and what we found
People using the service gave us mixed feedback regarding the availability and consistency of care staff. The potential negative impact upon people not receiving care, support and clinical interventions when needed was so significant we judged this to be a breach of regulations regarding staffing.
People received their medicines when they should. However, we made a recommendation about their medicines administration systems. Records relating to the planning of end of life care and mental capacity assessments were not based upon best practices. We recommended that the provider reviewed best practice guidance in both these areas.
Feedback regarding the administrative team was mixed with people reporting inconsistent communications. People experienced a service that needed to improve the way complaints were used to drive consistent quality provision. The quality assurance systems were not always sufficiently thorough to identify issues. The effectiveness of communication and organisation of the service therefore required improvements.
The care provided was rated highly by people in that they felt safe and the care received was of good quality. Staff ensured people's safety and acted when necessary to prevent any harm.
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. People received a thorough assessment which effectively supported achieving their desired outcomes. Comprehensive training and nurse led support ensured staff were competent to carry out complex health and social care. People were supported to maximise their health and well-being. People with often complex health conditions were supported to access their community.
People described care staff as kind and compassionate. They promoted people's independence and dignity. The provider ensured people’s individual characteristics were respected and supported. The provider involved people in decisions about their care and sought feedback regularly on the standard of care provided. People were positive about the registered manager’s approachability and support.
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)
This service was registered with us on 12/04/2018 and this is its first inspection.
Why we inspected
This was a planned inspection based on the service’s registration date.
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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.