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Archived: Ace Social Care Requires improvement

The provider of this service changed - see new profile

Reports


Inspection carried out on 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.

Inspection carried out on 25 September 2014

During an inspection looking at part of the service

Our inspection looked at three of our five questions; Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on speaking with the registered manager and the care staff supporting people who used the service, and looking at records. On this occasion we did not speak with people who used the service, but we took into account what they told us when we inspected the service earlier this year.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

At our last inspection on 16 April 2014 we found the company had not followed its own recruitment policy which aimed to make sure people working for the agency were of good character and suitable to work with vulnerable people. At this visit we found appropriate background checks had been carried out on new staff before they started to work at the agency. These made sure they were suitable to work with vulnerable people.

Is the service effective?

At our last inspection we found staff had not received appropriate professional development. At this visit additional training had been undertaken to help staff meet the needs of the people they supported. We also saw new staff were undertaking a structured induction programme to make sure they had the knowledge and skills to carry out their job.

We saw staff had received an annual appraisal of their work and supervision sessions had taken place periodically to make sure staff were following company policies.

Is the service well-led?

At our last visit we found the company had policies and procedures in place, but these had not always been followed. Staff recruitment and training files were disorganised and did not contain all the essential information required. At this inspection we found the registered manager had reorganised the staff files so information could be found easily.

We also found the policies and procedures regarding staff recruitment, training and support were now being followed. We were also told further work was underway to ensure all policies reflected good practice, as well as how the service intended to operate.

Inspection carried out on 15 April 2014

During a routine inspection

Our inspection looked at our five questions; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, speaking with the staff supporting them and looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us they were treated with respect and dignity by the staff who supported them. They said they felt their care and support was delivered in a safe way.

The company had policies and procedures in place to help protect people who used the service. We found most staff had received training in relation to safeguarding vulnerable people from abuse but some were unclear about who to contact outside the service if they needed to take their concerns elsewhere.

Some background checks had been carried out on staff before they started to work at the agency to make sure they were suitable to work with vulnerable people. However we found the provider had not always followed their recruitment policy when recruiting new staff. For example not all staff had completed an application form outlining their past employment and suitable written references had not always been obtained. This could lead to inappropriate staff being employed.

We saw there was a system in place to address any issue that arose and the complaints policy was made available to people in the agency�s welcome pack. No-one we spoke with highlighted any concerns or complaint.

We have asked the provider to tell us how they will make improvements and meet the requirements of law in relation to ensuring staff were recruited robustly.

Is the service effective?

People�s comments indicated staff were meeting their needs. However we found that not all staff had received all the training they required or regular formal support sessions. Staff told us they felt well supported by the manager, but confirmed they had not received a comprehensive structured induction to the agency or regular supervision sessions.

We have asked the provider to tell us how they will make improvements and meet the requirements of law in relation to ensuring staff received appropriate training and supervision.

Is the service caring?

People told us they were supported by friendly, thoughtful and caring staff. They said staff were mindful of their preferences regarding how they wanted things doing.

At the time of our visit the provider had not used surveys to gain people�s views but we saw this was underway. People we spoke with said the manager and care workers often asked them informally if they were happy with the support provided.

When we asked people if there was anything they would like to improve no-one raised any issues.

Is the service responsive?

We saw, and were told, that people�s needs had been assessed and where necessary a review of their care plan had taken place so it could be updated to reflect their changing needs.

People told us they knew how to make a complaint if they needed to. No-one raised any issues with us. When we looked at complaint records we saw no complaints had been received.

Is the service well-led?

There were systems in place to gain people�s views and check if staff were following company policies but these had not always been used effectively. When we asked people if there was anything they would like to improve they all said they were very happy with the care they received and could think of nothing they would change. One person said, �I can absolutely sing their praises.�

In the main, staff told us they were happy working for the agency and raised no concerns.

We saw the company had policies and procedures in place to inform people who used the service and to guide staff. However not all policies were being followed. For example the recruitment and training policies had not been adhered to and no-one had identified these shortfalls.