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Inspection carried out on 9 March 2017

During a routine inspection

This inspection took place on 9 March 2017 and was announced. We gave the registered provider 24 hours’ notice to ensure someone would be available at the service.

Aapna Services is a registered charity. The service specifically caters for people from the black minority ethnic communities in the Middlesbrough area providing culturally suitable services to enable people to live independently at home. The service is registered with the CQC to provide personal care to adults aged 18 and above. The service provides staff to support people with personal care as well as domestic duties, shopping, medical appointments and social outings.

We last inspected the service in January 2016 and rated the service as ‘Requires Improvement.’ We asked the registered provider to take immediate actions and at this inspection we found some improvements had been made to meet these regulations. However further improvements are required within management systems.

The service provides support to 52 people in their own homes, five of which required support with personal care.

The service had a registered manager in place. 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

During our inspection we found the organisation was multi-cultural and was underpinned by values and a genuine desire to be inclusive.

People were supported by enough staff, at the right times to meet their needs safely and in a person centred way. Person centred means when a person is central to their care and treatment and their needs are met in a personalised way taking on board their preferences.

Accidents and incidents were appropriately recorded and personalised risk assessments were in place for people who used the service and staff.

People were supported to administer their own medicines safely at home.

We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining and verifying references from previous employers to show staff employed were safe to work with vulnerable people.

Staff received regular supervisions and opportunities for further personal development. Some staff appraisals had taken place and other were planned.

Staff were suitably trained to meet the needs of the people who used the service and an appropriate induction took place for new starters.

Training needs of the staff were recorded but they were not always monitored.

Care records showed that people’s needs were assessed before they started using the service and care plans were written in a person centred way.

Staff supported people who used the service with their social, cultural and religious needs. People who used the service told us that all staff were very caring in the way they supported them.

People who used the service told us they were treated with dignity and respect and felt very comfortable with their staff. They told us how they had learned from each other and had built trust and important relationships together.

People who used the service were aware of how to make a complaint if they needed too and complaints were managed appropriately.

The service had onsite facilities and activities for people to access.

Staff told us they felt supported by the registered manager and were comfortable raising any concerns.

The service had a range of audits in place to check the quality and safety of the service and actions plans and lessons learnt were part of their on-going quality review of the service. However quality assurance with the people who used the service was planned but at the time of our inspection hadn’t taken place.

The service worked in partnership with the local authority an

Inspection carried out on 28 January 2016

During a routine inspection

We inspected Aapna Services on 28 January 2016. This was an announced inspection. We informed the registered provider at short notice [48 hours before] that we would be visiting to inspect. We did this because we wanted the registered manager to be present at the service on the day of the inspection to provide us with the information we needed.

Aapna Services Limited is a registered charity. The service specifically caters for people from black minority ethnic communities providing culturally suitable services to enable people to live independently at home. The service is able to provide personal care and support to adults aged 18 and above. The service provides staff to support people with personal care as well as domestic duties, shopping, medical appointments and social outings. At the time of the inspection the service was providing personal care at home to three people.

The service had a registered manager in place. 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 service did not undertake a full environmental risk assessment to clearly identify risks within the environment, to the person or staff member providing assistance. Risks assessments for people who used the service were insufficiently detailed. This meant that staff did not have the written guidance they needed to help people to remain safe.

Systems were not in place for the management of medicines to make sure that people received their medicines safely.

Staff had not received an annual appraisal. The registered manager told us mandatory training for staff was up to date; however, records were not available to confirm this. Staff had not received training in the Mental Capacity Act 2005.

We looked at the arrangements in place for quality assurance and governance. Quality assurance and governance processes are systems that help providers to assess the safety and quality of their services, ensuring they provide people with a good service and meet appropriate quality standards and legal obligations. Effective quality monitoring systems were not in place to ensure the service was run in the best interest of people who used the service.

These were breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we took at the back of this report.

Some improvement was needed to ensure appropriate checks were completed on staff before they started work.

There were enough staff employed to provide support and ensure that people’s needs were met.

There were systems and processes in place to protect people from the risk of harm. Staff were aware of the different types of abuse and what would constitute poor practice.

Staff told us that the registered manager was supportive. We saw that staff had received supervision on a regular basis.

People were treated with dignity and respect. Staff were attentive, showed compassion and encouraged people to be independent.

People were provided with their choice of food and drinks which helped to ensure that their nutritional needs were met.

Staff at the service worked with other healthcare professionals to support people. Staff worked and communicated with social workers, occupational therapists and hospital staff as part of the assessment, ongoing reviews and care package.

The registered provider had a system in place for responding to people’s concerns and complaints. People told us they knew how to complain and felt confident that staff would respond and take action to support them.

Inspection carried out on 29 January 2014

During a routine inspection

At the time of the inspection this service provided support to a number of people who needed help with domestic duties, shopping and to attend medical appointments, however only one person who used the service required personal care. As part of the inspection we spoke with the relative of the person who required help with personal care and support. We also spoke with the manager and a support worker.

The relative we spoke with told us that the person who used the service was well supported. We were told that the agency provided a reliable service. The relative said, “He / she is very happy with the help they get.”

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

Peopled were supported by, suitably qualified, skilled and experienced staff. We found that the provider had effective recruitment procedures and that relevant checks were carried out on staff to ensure that they were suitable to work with children and young people