14 April 2021
During an inspection looking at part of the service
Angel Human Resources Limited (London Bridge) is a domiciliary care service providing personal care to 61 people at the time of the inspection.
Not everyone who used the service received personal care. 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.
People’s experience of using this service and what we found
Medicines were not always managed safely as staff were not always completing the records in line with the provider’s policy. Risks were not always effectively managed as there was at times a lack of information provided to staff to help them mitigate risks when providing care. The provider’s processes for recording and investigating incidents and accidents were not always effective.
The provider did not have effective quality assurance systems in place to monitor, manage and improve service delivery and to improve the care and support provided to people.
We made a recommendation to the provider to ensure they had effective recruitment processes in place. There were enough staff deployed to provide care and support. Staff received training and supervision in line with the provider’s policy.
The provider had made some improvements to how the service was managed. These included reviewing all policies and procedures and introducing new processes for recording how care was being delivered.
The manager had only recently started working at the service. They had started to introduce a range of audits as they had identified there were gaps in how the service was being monitored.
Staff understood the provider's safeguarding policies and were familiar with the reporting procedures. Staff had access to appropriate personal protective equipment (PPE) to help prevent the spread of infection.
On the whole people told us they felt safe and gave positive feedback. Relatives also told us they were happy with the care their loved ones received from the service. There was a positive culture amongst the care staff, they told us they felt supported in their roles and enjoyed working for the service. People were able to provide feedback via a survey on the quality of the care and support they received.
Rating at last inspection and update.
The last rating for this service was requires improvement (report published 23 September 2019) and there were multiple breaches of regulation for safe care and treatment, staffing and good governance. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvements had not been made and the provider was still in breach of regulations 12 and 17.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection. We have found evidence that the provider needs to make improvements. Please see the safe, effective, and well led sections of this report. You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Angel Human Resources (London Bridge) on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to safe care and treatment, staff recruitment and good governance. Please see the action we have told the provider to take at the end of this report.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.
We will request an action plan for 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.