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Reports


Inspection carried out on 6 September 2018

During a routine inspection

The office visit of this inspection took place on 6 September 2018 and was announced.

Acme Care Ltd is a domiciliary care agency registered to provide personal care to people in their own homes. At the time of this inspection the service supported 19 people and employed 28 care staff. Three people who used the service required regular support with personal care, other people required assistance to access community facilities. Staff provided personal care to people accessing community facilities when needed. Some people received support 24 hours a day, while other people received support at pre- arranged times.

At our last comprehensive inspection of the service in December 2015 we rated the service as Good. At this inspection we found the service remained Good.

A requirement of the provider’s registration is that they have a registered manager. There was a registered manager in post at the time of our inspection. The registered manager was also an owner of the company, and the providers ‘nominated individual’ for the service. 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 received care which protected them from avoidable harm and abuse. Staff understood people’s needs and knew how to protect them from the risk of abuse. Risks to people’s safety were identified and assessments were in place to manage identified risks. Where people required support to take prescribed medicines, staff had received training to assist people safely.

There were enough skilled and experienced staff to meet the needs of people who used the service. People were supported by staff who had the skills and training to meet their needs. Recruitment checks were completed on new staff to ensure they were suitable to support people who used the service.

The managers and staff understood their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were involved in making every day decisions and choices about how they wanted to live their lives.

People were supported by a team of regular staff that they knew and who they said were kind and caring. Staff respected people's privacy and dignity and promoted their independence. Relatives and people said the support they received helped people who used the service live independently in their own homes.

The service was responsive to people’s needs and wishes. People were provided with care and support which was individual to them. Support plans were detailed and personalised. Plans provided guidance for staff about how to support each person in the way they preferred. People’s care and support needs were kept under review and staff responded when there were changes in these needs. Where required, people were supported to have sufficient to eat and drink and their health needs were regularly monitored.

The service continued to be well led. Staff said they received good support from the management team who were always available to give advice. Managers and staff told us there was good team work and that all staff worked well together. There were effective and responsive processes for assessing and monitoring the quality of the service provided.

Inspection carried out on 1 December 2015

During a routine inspection

Acme Care Limited is a domiciliary care agency which provides personal care support to people in their own homes. At the time of our visit the agency supported 29 people with personal care and employed 36 care workers.

We visited the offices of Acme Care Limited on 1 December 2015. We told the provider before the visit we were coming so they could arrange for staff to be available to talk with us about the service.

The service has 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 felt safe using the service and care workers understood how to protect people from abuse. There were processes to minimise risks to people’s safety; these included procedures to manage identified risks with people’s care and for managing people’s medicines. Checks were carried out prior to care staff starting work to ensure their suitability to work with people who used the service.

The registered manager understood the principles of the Mental Capacity Act (MCA). Care workers respected people’s rights to make their own decisions and gained people’s consent before they provided personal care.

People had consistent care workers who arrived on time and stayed the agreed length of time. There were enough suitably trained care workers to deliver care and support to people. Care workers received an induction to the service and completed a programme of training to support them in meeting people’s needs effectively. People told us care workers were kind and caring.

Care plans and risk assessments contained relevant information for staff to help them provide the personalised care people required. People knew how to complain and information about making a complaint was available for people. Staff said they could raise any concerns or issues with the registered manager, knowing they would be listened to and acted on.

There were processes to monitor the quality of the service provided and understand the experiences of people who used the service. This was through regular communication with people and staff, returned satisfaction surveys, spot checks on care workers and a programme of other checks and audits.

Inspection carried out on 17 July 2014

During an inspection in response to concerns

We visited Acme Care Ltd on 17 July 2014 due to concerns raised with us about recruitment of staff and training made available to staff to meet people's needs. During this visit we met the registered manager, a senior manager and a newly recruited member of staff. Following our visit we spoke with five members of care staff via telephone. We did not speak with any people who used the service or their relatives on this occasion.

A concern we received related specifically to staff commencing work before an appropriate criminal record check by the Disclosure and Barring Service (DBS) had been received. Concerns relating to training were about training in moving and handling, artificial feeding (peg feeding) and the buccal administration of medication, which is where medication is administered between a person's bottom lip and gum .

We found robust recruitment processes were in place to ensure that staff employed by the provider were suitable to work with vulnerable people. New staff commenced their office based induction and shadow shifts whilst their DBS check was applied for. They commenced lone working when their DBS check had been received and deemed satisfactory.

Staff received training to ensure that they were competent to provide the care and support for people which enabled them to carry out their roles effectively.

Inspection carried out on 20 February 2014

During an inspection looking at part of the service

When we visited Acme Care on 21 October 2013 we found the provider was not meeting the required standard for ensuring people�s care and welfare needs were managed safely.

This was because identified risk associated with people�s care and support was not being managed consistently. For example, how people with restricted mobility were to be moved safely, the prevention process in place for people prone to falling, and pressure area management for people who required assistance to move around to prevent pressure sores developing on the skin. We set a compliance action that let the provider know they needed to improve. We also asked the provider to send a report to tell us what they had done to become compliant.

In November 2013 we received a report from the provider that told us what they had done and what they planned to do to improve the service provided.

We visited the service 20 February 2014 to check the actions taken by the provider and to make sure improvements had been made. We did not speak to people who used the service during this follow up visit. This report should be read in conjunction with the inspection report from 21 October 2013.

We found the provider had implemented the required improvements. People who used the service could be confident that their care and welfare needs were managed safely.

Inspection carried out on 21 October 2013

During a routine inspection

At the time of our visit the agency supported 45 people. Eighteen of these people received a personal care service. Other people received support to attend community activities and a few had help with domestic work.

We spoke with the manager, deputy manager, two assistant managers and three care workers during our visit. We also spoke with four people who used the service an advocate and two relatives to find out their views about Acme Care.

People who used the service said they received the care and support they had agreed to. People who were unable to make their own decisions had a family member or an advocate that acted on their behalf.

The care plans we looked at provided staff with detailed information about the care and support people required. We found improvements were needed in managing risks associated with people�s care to make sure people remained safe and well.

Acme Care had a safe procedure for assisting people with medication and people received there medicines as prescribed.

People we spoke with said they had regular care workers who were friendly and polite. We were satisfied care workers had been recruited safely and had the necessary skills and experience to work with people using the service.

Records showed the agency had systems in place to monitor the care provided. Everyone we spoke with told us they were happy with the care they received. People told us, �I am more than happy with the care and support X receives. I think it�s excellent.� Another said �Brilliant service, they understand X and how he likes things done.�