9 June 2023
During a routine inspection
Axiom Home Care Hemel Hempstead is a domiciliary care agency (DCA). The service provides personal care services to people in their own homes. At the time of our inspection 7 people were receiving personal care from 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
People did not always have assessments carried out when needs were identified. The lack of assessments placed people at risk of avoidable harm. People felt safe with the care provided and staff reported concerns when needed, although there were delays by the provider in investigating those concerns.
People received their medicines as required but improvements were required in maintaining medicines records. People received care from a consistent staff team, however they also told us their agreed times were not always met promptly.
Staff had received training, but the quality of this training did not always enable them to meet people's needs effectively. Training in some key areas had not been provided to staff. Staff felt supported by the management team, but further improvement was required to plan, develop, and review staff performance.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
People were not always supported to have a choice about who provided their personal care. We have made a recommendation about ensuring people's dignity is met.
There was a lack of oversight of the quality of care provided with shortfalls that had not been identified by the provider. Staff had not ensured they maintained good records in relation to people's support needs.
People were happy with the care provided. They told us staff treated them with respect, promoted their independence and were kind and caring when supporting them. People were confident that concerns or complaints would be managed promptly.
People received care they felt was appropriate to their needs and kept them safe from harm. The ongoing risks associated with people's individual care needs were managed safely.
Staff wore personal protective equipment [PPE] when providing care to people to keep them protected.
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 on 17 November 2020, and this is the first inspection.
Why we inspected
This was a routine inspection based on information we held about the service.
Enforcement and Recommendations
We have identified breaches in relation to safe care and treatment, person centred care, training and development, consent, and governance.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect. 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.
This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and video and phone calls to engage with people using the service as part of this performance review and assessment.