Background to this inspection
Updated
8 June 2019
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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection team consisted of one inspector, two assistant inspectors and two 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.
Service and service type:
Agincare UK Wolverhampton is a domiciliary care agency. It provides personal care to people living in their own homes. Not everyone using Agincare UK Wolverhampton received the regulated activity of personal care; the Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. At the time of our inspection, 170 people were receiving personal care.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are 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 24 hours’ notice of the inspection visit because it is a small service and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.
What we did:
We reviewed information we had received about the service. This included statutory notifications that the provider had sent us. A statutory notification is information about important events which the provider is required to send us by law. We sought feedback from the local authority and other professionals who work with the service. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
We visited the office location on 08 May 2019 to see the registered manager; and to review care records and policies and procedures. We made calls to people, their relatives and staff on 07, 08, 09 and 14 May 2019.
During our inspection we spoke with 10 members of staff including the registered manager, 10 people using the service, and 14 relatives.
We reviewed a range of records. This included seven people's care records, four staff files around staff recruitment and supervision and the training records for all staff. We also reviewed records relating to the management of the service and a variety of policies and procedures developed and implemented by the provider.
Updated
8 June 2019
About the service:
Agincare UK Wolverhampton is a domiciliary care agency who are registered to offer support to; Children 0-18 years, Dementia, Learning disabilities or autistic spectrum disorder, Mental Health, Older People, Physical Disability, Sensory Impairment and Younger Adults.
It provides personal care to people living in their own homes. Not everyone using Agincare UK Wolverhampton received personal care. At the time of our inspection, 170 people were receiving personal care.
People’s experience of using this service:
Improvements were required to medicines management.
People’s Medicine administration record sheet did not contain enough information required to administer the medicines correctly.
Risk assessment were not personal to people.
Some people’s risk assessments and care plans had not been reviewed, however people told us they were fully involved when review occurred.
Care plans were not always person centred and did not always document people’s choices, however people told us they had regular staff who they knew well and that they were involved in the care planning process.
Not all staff had received training in nutrition or end of life care.
The registered manager completed audits however, these did not effectively pick up issues or identify actions needed. For example, when staff required refresher training.
People told us they felt safe with staff.
Staff had a good understanding of abuse and the actions they should take if they had any concerns that people were at risk.
The provider carried out safe recruitment processes.
Staff followed infection prevention and control procedures to protect people from infection.
People told us that staff were good and knew what to do. One person said, “Staff understand what I need and do it well.”
The provider supported people with their healthcare needs, including referring to services such as speech and language therapists, district nurses and GP’s as required.
Staff ensured people were involved in decisions about their care; and knew what they needed to do to make sure decisions were taken in people's best interests.
People told us that they had good relationships with staff, we were told that staff were ‘caring, kind and polite.’
The registered manager matched staff skills to meet people’s specific needs where they were able.
People received a weekly schedule to inform them of which staff would be visiting.
People were supported to maintain their independence, privacy and dignity.
People, relatives and staff all knew how to complain and who to talk to if they had any concerns.
People were protected against discrimination. There was a policy which covered the Equality Act 2010 and protected characteristics.
Most people we spoke to stated they would recommend the services of Agincare to other people.
The service met the characteristics for a rating of ‘requires improvement’’ in four of the five key questions we inspected and a rating of ‘good’ in one. Therefore, our overall rating for the service after this inspection was ‘requires improvement’.
More information is in the full report.
Rating at last inspection:
At the last inspection the service was rated Good. (Report published 28 September 2016)
Why we inspected:
This inspection was a planned inspection.
Enforcement:
At this inspection we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the registered provider to take at the back of the full version of the report.
Follow up:
Going forward we will continue to monitor this service and plan to inspect in line with our reinspection schedule for services rated Requires Improvement.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk