10 August 2015
During a routine inspection
The inspection took place on 10 August 2015 with the provider being given short notice of the visit to the office in line with our current methodology for inspecting domiciliary care agencies. The service was previously inspected on 15 April 2014, when a breach of legal requirements were identified. Therefore we carried out a follow up inspection on 25 September 2014 to check if the provider was meeting the legal requirements, we found they were.
Ace Social Care provides personal care to people living in their own homes. Its office is based near the centre of Maltby. The agency mainly supports older people and younger people with a physical disability.
The service had a registered manager in post at the time of our inspection. 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 and associated Regulations about how the service is run.
At the time of our inspection there were 14 people receiving support with their personal care. We spoke with three people who used the service and three relatives about their experiences of using the agency. They told us they were very happy with the service provided.
People’s needs had been assessed before their care package commenced and they, and the relatives we spoke with, told us they had been involved in formulating and updating care plans. The information contained in the care records we sampled was individualised and identified people’s needs and preferences, as well as any risks associated with their care and the environment they lived in.
We found people received a service that was based on their personal needs and wishes. The majority of the time we found changes in people’s needs had been quickly identified and their care package amended to meet the changes. However, in one file we saw there was no information about how to minimise the risk of pressure damage. Although staff knew about this person’s needs and provided appropriate care, the lack of written guidance meant that new staff would not have all the information they needed to care for the person correctly.
Where people needed assistance taking their medication this was administered in a timely way by staff who had been trained to carry out this role. However, we found the service had failed to make accurate records of medicines given, which could lead to people not receiving the correct medicines at the right time. This was 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.
Policies and procedures were in place covering the requirements of the Mental Capacity Act 2005 (MCA), which aims to protect people who may not have the capacity to make decisions for themselves. The Mental Capacity Act 2005 sets out what must be done to make sure that the human rights of people who may lack mental capacity to make decisions are protected, including balancing autonomy and protection in relation to consent or refusal of care or treatment.
We found the service employed enough staff to meet the needs of the people being supported. We saw people had a team of care staff who visited them on a regular basis. People who used the service praised the staff who supported them and raised no concerns about how their care was delivered.
There was a recruitment system in place that helped the employer make safer recruitment decisions when employing new staff. The staff we spoke with confirmed they had received an induction and essential training at the beginning of their employment. We saw this had been followed by periodic refresher training to update their knowledge and skills. Although we found staff had not received formal support sessions on a regular basis, they told us they felt well supported by the management team.
The company had a complaints policy, which was given to people at the beginning of their care package. No complaints had been recorded since our last inspection and the people we spoke with did not identify any concerns. However, there was no system in place to record the details of any complaints made, action taken and the outcome.
The provider had used annual surveys, care reviews and direct observation of staff to enable people to share their opinion of the service provided and check staff were following company polices. However there was little evidence that the information had been analysed and acted upon, and the outcome shared with people who used the service.
We found there was no clear system in place to monitor how the service was operating. For example, although the registered manager said they checked care records when they were returned to the office there was no system in place to record their findings and what action had been taken to address shortfalls. This was 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.
We saw there were policies and procedures available to inform and guide staff and people using the service. However, there was no evidence they had been reviewed to make sure they reflected current best practice.