Archived: Access Care Management Limited

Updated 17 September 2015

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.

This inspection took place on 21 and 23 July 2015 and was announced. The provider was given 48 hours’ notice because we needed to be sure the office would be open and we would be able to speak with people. The inspection team consisted of one inspector and an Expert by Experience who spoke with people, relatives and a care worker. An Expert by Experience is a person who has had personal experience of using or caring for someone who uses this type of service. The Expert by Experience had friends who used domiciliary care. This is where care is provided in a person’s own home.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the completed PIR and previous inspection reports before the inspection. We checked the information that we held about the service and the service provider.

Due to the service being provided to people across the country we visited and spoke with one person in their home that lived locally and their care worker. We also spoke with the registered manager and one office staff member.

After the inspection we spoke with an additional two people who use the service, four relatives and three care workers. Other relatives and two people were contacted however did not wish to speak with us telling us they were happy with the care which was provided.

We reviewed a range of records about people’s care and how the service was managed. These included care records for six people, daily care notes for three of these people, daily care notes for one other person, four medicine administration records (MAR) and other records relating to the management of the service. These included four care worker training, registration and employment files, business continuity information, three care worker spot checks, policies and procedures as well as care worker and quality assurance conversations.

The previous inspection was carried out in December 2013 and no concerns were raised.

Updated 17 September 2015

The inspection was announced and took place on the 21 and 23 July 2015.

Access Care Management is a small family run care service which provides personal care and support to people who live in their own homes across the country. People who receive the service include those living with dementia, people with disabilities such as cerebral palsy and those living with brain injuries. At the time of the inspection the service was providing personal care to 22 people. Care was provided by care workers who lived with people in their own homes.

Access Care Management has a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People using the service told us they felt safe. Care workers understood and followed guidance to recognise and address safeguarding concerns.

People’s safety was promoted because risks that may cause harm in their home and local community had been identified and managed. People were supported by care workers who encouraged them to remain independent. Appropriate risk assessments were in place to keep people safe.

Access Care Management did not directly employ care workers. Care workers were self-employed and registered with the service in order to deliver care. Recruitment procedures were not fully completed in order to protect people from the deployment of unsuitable care workers. The provider had not ensured that a full employment history had been obtained from care workers. This is required to make sure care workers can explain any gaps in employment when they have been working with adults who are vulnerable. However the provider however obtained character and professional references to ensure care workers suitability for the role.

People were protected from the unsafe administration of their medicines because care workers were trained to administer medicines safely. Care workers completed mandatory training to ensure that medicines were being administered, stored and disposed of correctly. These skills were reviewed on a regular basis by appropriately trained office staff to ensure that care workers were competent in the completion of their role.

People were supported by care workers to make their own decisions. Care workers were knowledgeable about the requirements of the Mental Capacity Act 2005 (MCA 2005). The service worked with people, relatives and healthcare professionals when required to assess people’s capacity to make specific decisions for themselves. Care workers sought consent before carrying out care, treatment and support.

People were supported to eat and drink enough to maintain their nutritional and hydration needs. People told us they were able to choose their meals. Records showed people’s food and drink preferences were documented in care plans and were known by care workers.

People’s health needs were met as the care workers and registered manager promptly engaged with other healthcare agencies and professionals to maintain people’s safety and welfare.

Care workers demonstrated that they knew and understood the needs of the people they were supporting. People told us that their care was provided to a good standard. The registered manager and care workers were able to identify and discuss the importance of maintaining people’s respect and privacy at all times. People were encouraged and supported by care workers to make choices about their care.

Care plans were personalised to each individual. They contained detailed information to assist care workers to provide care in a manner that respected that person’s individual needs and wishes. Relatives told us and records showed they were actively encouraged to be involved at the care planning stage, during regular review and when their family member’s health needs changed.

People knew how to complain and told us they were happy to do so if this was required. Procedures were in place for the registered manager to monitor, investigate and respond to complaints in an effective way. People, relatives and care workers were encouraged to provide feedback on the quality of the service during regular telephone conversations with the manager and office staff.

The provider’s values were communicated to people and care workers. Care worker understood these and people told us these standards were evidenced in the way care was delivered.

The registered manager and care workers promoted a culture which focused on providing person centred care. People were assisted by support workers who were encouraged to raise concerns with the registered manager and office staff. The provider had a routine and regular quality monitoring process in place to assess the quality of the service being provided. This open and supportive process allowed for people, relatives and the care workers to provide feedback.

Care workers told us they felt supported by the registered manager and office staff.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.