Background to this inspection
Updated
15 July 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 was completed by one inspector.
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.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 14 June 2022 and ended on 24 June 2022. We visited the location’s office on 14 June 2022.
What we did before the inspection
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We sought feedback from the Local Authority and professionals who work with the service. We used all this information to plan our inspection.
During the inspection
During the inspection we spoke with the registered manager. We reviewed a range of records including three people's care and support plans, risk assessments and daily care notes. We reviewed two people’s medication administration records. We also reviewed four staff personnel files, staff training and supervision records. We reviewed records used in managing the service, for example, satisfaction surveys.
After the inspection
We contacted and spoke with three members of staff and spoke with two people who use the service and one relative.
Updated
15 July 2022
About the service
Andrea Healthcare Limited is a domiciliary care service providing personal care to people living in their own houses, flats and specialist housing. Andrea Healthcare Limited primarily supports older people and people who are judged to be at the end of their life. At the time of inspection there were eight people using the service, of which all were receiving the regulated activity of ‘personal care’.
People’s experience of using this service and what we found
Improvements were required to ensure the proper and safe use of medicines. Staff recruitment practices and procedures were not as robust as they should be, we have made a recommendation about this within the report. The service understood staff require training, but improvements are required to ensure staff are appropriately trained, are skilled and competent to undertake their role. Staff did not routinely receive formal supervision. The provider’s governance arrangements had failed to identify the above shortfalls.
People and those acting on their behalf told us they or their family member was safe, and they had no concerns about their safety. Suitable arrangements were in place to protect people from abuse and avoidable harm. Staff understood how to raise concerns and knew what to do to safeguard people. Risks for people were identified and recorded in relation to their care and support needs. People confirmed they had not experienced any occasions whereby they had not received support from the domiciliary care service, for example, missed calls.
Staff made sure people were involved in making decisions about their care and support. People were supported to have maximum choice and control of their lives and staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported did not support this practice. People were supported to eat and drink enough to maintain their health and wellbeing. The service monitored people’s health, care and support needs to promote positive outcomes and to ensure people were supported at the end of their life.
People told us they were treated with care and kindness. Overall people were very happy with the domiciliary care service provided. People confirmed care and support was provided by regular staff and they were always treated with respect and dignity.
People’s care and support needs were identified and recorded. Staff confirmed they had all of the information required to meet people’s needs. People and those acting on their behalf were confident that if they complained, this would be taken seriously and acted on.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us in November 2020 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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 medicines management, staff training and governance arrangements 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.