Hilltop Works

Suite 8 Old Anglo House is a domiciliary care agency providing personal care. The service provides support to people living in their own homes. At the time of our inspection there were 15 people using the service.

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.

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

The provider had failed to operate robust recruitment procedures, including undertaking relevant checks on prospective staff. People's care plans and risk assessments were not always regularly updated. The provider failed to ensure the service was being managed effectively and failed to ensure comprehensive quality and safety monitoring. Medicine management was not always safe as records were not always in place and checked regarding people's current prescribed medicines.

We have made recommendations about the recruitment and training of staff.

Most people told us they were not aware of the content of their care plan and did not have a copy. This meant people were not always fully involved in making decisions about their care. Staff supported people to maintain relationships that mattered to them, such as family, community and other social links.

People told us they felt safe whilst receiving care from staff. People's privacy and dignity were respected, and independence encouraged. People did not feel rushed by staff while they were receiving personal care.

People told us they felt staff were well trained. People felt staff supported them with maintaining a good quality of life. People were supported with their nutrition and hydration when this was required. People told us they were happy with the support they received to eat and drink. Staff knew what they needed to do to make sure decisions were taken in people's best interests and involved the right professionals or next of kin when needed.

People received support from kind and caring staff. People told us they, or their relatives, were involved in making initial decisions about the care they received.

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

Rating at last inspection

The last rating for this service at their previous premises was good (published 29 December 2016).

Why we inspected

The inspection was prompted in part due to concerns received about the service operating outside of their registration. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

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 and will take further action if needed.

We have identified breaches in relation to the provider’s recruitment practices and the leadership of the service at this inspection.

You can see what enforcement action we have taken 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 return as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At our last inspection on 16 March 2015, we asked the provider to take action to make improvements to their procedures for monitoring and improving the service. This action has been completed.

BM Care Management Solutions is a home care agency based in Earl Shilton in Leicestershire. It supports people who live in their own homes. At the time of our inspection six people used the service.

The service had a registered manager. 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 2008 and associated Regulations about how the service is run.

People who used the service were safe. They told us they felt comfortable with and trusted the care workers who supported them. Staff were recruited under procedures that ensured only people suited to work at the service were employed. Staff understood and applied their responsibilities for protecting people from abuse and avoidable harm. They advised people about how to keep safe in their homes.

People’s care plans included risk assessments of activities associated with their personal care routines. The risk assessments provided information for care workers that enabled them to support people safely but without restricting their independence.

Enough suitably skilled and knowledgeable care workers were deployed to meet the needs of the people using the service. Care workers regularly supported the same people and therefore understood their needs.

People were supported to take their medicines at the right times by staff that were trained in medicines management.

Care workers were supported through supervision and training. People who used the service told us told us they felt staff were well trained and competent.

The registered manager understood their responsibilities under the Mental Capacity Act (MCA) 2015. Staff had awareness of the MCA and understood they could provide care and support only if a person consented to it and if the proper safeguards were put in place to protect their rights.

Staff supported people to have meals. They also supported people to access health services when they needed them.

People were involved in decisions about their care and support. They received the information they needed about the service and about how the service could support them.

People told us they were treated with dignity and respect. The registered manager actively promoted values of compassion and kindness in the service and care workers shared those values.

People contributed to the assessment of their needs and to reviews of their care plans. Their care plans were centred on their individual needs. People knew how to raise concerns if they felt they had to and they were confident they would be taken seriously by the provider. When people expressed preferences about their care and support these were acted upon by the service.

The provider had effective arrangements for monitoring the quality of the service. These arrangements included asking for people’s feedback about the service and a range of checks and audits. The quality assurance procedures were used to identify and implement improvements to people’s experience of the service.