Archived: Anna Rosa Care

Updated 22 February 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection team consisted of an inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

The inspector visited the office and made telephone calls to staff. The Expert by Experience made calls to people and their relatives about their experience of using the agency.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.

The service had a manager registered with the Care Quality Commission who was also the provider and legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 72 hours’ notice of the inspection. This was because we needed to be sure the provider would be in the office to support the inspection.

What we did before the inspection

We reviewed information we had received about the service and sought feedback from professionals who commissioned a service from this provider. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection-

We spoke with five people who used the service and five relatives about their experience of the care provided. We spoke with five staff including the registered manager.

We reviewed a range of records. This included three people’s care records and three staff files in relation to recruitment and training. A variety of records relating to the management of the service such as complaints and surveys were reviewed.

Updated 22 February 2022

About the service

Anna Rosa Care is a domiciliary care service providing personal care to people living in their own homes. 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. At the time of the inspection there were 21 people receiving personal care support.

People’s experience of using this service and what we found

Staff were not provided with clear guidance on how to reduce risks to people’s safety. Strategies which were put in place were not always recorded.

Medicine management required improvement. Medicine administration records were not always fully completed, and there were no medicine profiles or controls for overseeing stock.

Incidents were not always identified and reviewed in a systematic way to reduce the likelihood of a reoccurrence.

While some training for staff was provided, there were no competency assessments to check staff’s understanding or spot checks to review care delivery.

Assessments and care plans did not always contain sufficient information. We have made a recommendation about the assessment process.

The management oversight of the service needed improvement and audits developed to monitor the quality of care.

Staff were clear about escalating safeguarding concerns but were less clear about the role of the Local Authority.

The agency had recently experienced a challenging period with staff sickness. People told us the agency had been stretched but things were improving, and they were supported by a consistent team of care staff who stayed for the allocated time.

We identified some shortfalls in recruitment processes, but improvements to processes were actioned during the inspection.

Infection control procedures were in place and staff wore personal protective equipment and undertook testing. Screening of visitors to the office needed improvement.

Support was provided to people with eating and drinking as outlined in their assessment, but staff required further guidance in relation to the management of specific health conditions.

The recording of best interests decisions needed improvement and we have made a recommendation regarding this.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People spoke highly of the care staff describing them as friendly and kind. People were enabled to be independent as they were able, and their privacy was respected. Although there was a lack of detail in care plans, staff demonstrated that they knew people well.

There was a complaints procedure in place but was not always followed and complaints were not always recorded in a way that enabled learning. We received contradictory information about how complaints were managed.

The registered manager responded to our inspection in a positive way and was open about the shortfalls. However, duty of candour was not well understood, and incidents had not always been reported to CQC as required.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

This service was registered with us on 24 September 2019 and this was the first inspection.

Enforcement and Recommendations

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 and will take further action if needed.

We have identified breaches in relation to risk, staff training and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.