Archived: Abafields Home Care Services Ltd

Abafields Homecare Service is a Domiciliary Care Agency (DCA) providing a service to older adults, some of whom may have dementia, with a varying level of personal care needs. Staff provided care to people living in their own homes. At the time of inspection, the service was supporting 21 people. 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

The current manager had not yet registered with CQC but had started the application process. They had only been in post for several weeks and had also been recruited by the provider to manage their residential setting. The manager advised at the start of the inspection they had raised concerns with the provider that the service had not been set up safely and it needed to be closed. This was because care was being provided to people without appropriate records being completed. These included risk assessments, medication administration records (MAR’s), daily records and support plans. In addition, support plans had limited information and only provided a profile for each person.

Some people did not have a care file set up in their home, to guide staff on what support they needed. Two people and one staff reported that information was shared with staff by people and relatives on what support they needed. Accidents and incidents had not been logged appropriately and safeguarding systems were not in place.

Quality improvement systems were not in place and audits had not been completed in line with the providers policies. Policies were in place, but they had not always been followed and the providers procedures did not reflect the guidance they provided. The manager had identified a significant amount of systems that needed to be implemented; however, the time they were able to allocate improving the homecare service was limited by their role as manager of the providers residential home.

Staff had not been recruited safely, references were not always requested and there was no evidence of interviews being completed appropriately. A robust induction had not always been carried out by new starters and there were gaps in other recruitment records. Several staff had recently left after the manager readjusted salaries to reflect the amount of time a person had been supported, which had left the service short staffed. The manager stated the deputy manager and care co-ordinator positions, were roles the provider had agreed to recruit; however, at the time of inspection there were no candidates identified.

People were not supported to have maximum choice and control of their lives. However, staff supported them in the least restrictive way possible and in their best interests; the systems in the service did not support this practice. People felt well cared for by the care staff.

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

Rating at last inspection (and update)

This service was registered with CQC on 23 February 2020 and this was the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about people not receiving support as scheduled, medicines being unavailable and medication records not being in place. Further concerns were raised about care not being assessed appropriately and people not receiving important support they needed such as continence and dietary care. A decision was made for us to inspect and examine those risks.

We have found evidence the provider needs to make improvements. Please see all the sections of this full report.

The overall rating for the service has been assessed as inadequate. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Abafields Homecare Services 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 have identified breaches in relation to person centred care, need for consent and safe care and treatment. Further breaches were identified in receiving and acting on complaints, good governance, fit and proper persons and staffing at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded

Follow up

Following the inspection the provider contacted CQC to inform they were deregistering the service and would be handing back packages of care to the local authority. We monitored the process to ensure people's care was handed back to the local authority in a safe way.

The overall rating for this service is ‘Inadequate’ and the service would have been in ‘special measures’, had it not decided to deregister. This means we would have kept the service under review.

If the provider had not made enough improvement within this timeframe. And there was still a rating of inadequate for any key question or overall rating, we would have taken action in line with our enforcement procedures. This means we would have begun the process of preventing the provider from operating the service. This would usually lead to cancellation of their registration or to varying the conditions the registration.