We carried out a review of the data available to us about ASK Care Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about ASK Care Limited, you can give feedback on this service.
ASK Care Limited is a domiciliary care agency providing the regulated activity of personal care. The service provides support to younger and older adults and children. At the time of our inspection, there were 145 people using the service, but only 104 of those received support with 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 and relatives we spoke with gave very positive feedback. This was summed up by a relative who told us, “I would give them a 10/10. We’ve been with them a long time. They communicate well, they know [person] and we have a really good relationship."
Systems were in place to help safeguard people from abuse. Risk assessments were in place which set out the risks people faced and included information about how to mitigate those risks. There were enough staff to meet people's needs and robust staff recruitment practices were in place. Steps had been taken to help prevent the spread of infections. Accidents and incidents were reviewed to help prevent their re-occurrence. medicines were managed in a safe way.
Quality assurance and monitoring systems were in place to help drive improvements at the service. There was an open and positive culture at the service, which meant people, relatives and staff could express their views. The provider worked with other agencies to develop best practice and share knowledge.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was Requires Improvement (published 15 January 2021).
Why we inspected
We carried out an announced inspection of this service on 11 December 2020. Breaches of legal requirements were found in relation to Regulation 12 (Safe Care & Treatment), Regulation 18 (Staffing) and Regulation 17 (Good Governance) The provider completed an action plan after the last inspection to show what they would do and by when.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led, which contain those requirements. At this inspection we found the provider was no longer breach of regulations.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Requires improvement to Good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for ASK Care Limited on our website at www.cqc.org.uk
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
ASK Care Limited is a domiciliary care agency providing personal care to people living in their own homes. At the time of inspection 252 people were 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
Medicines were not always managed in a way that was safe. Staff were often late to see people and they did not always stay for the full amount of time allocated for the visit. The provider did not have effective systems in place for monitoring and improving the quality of care and support provided.
Systems were in place to safeguard people from the risk of abuse and staff were aware of their responsibility for reporting allegations of abuse. Risk assessments were in place which included information about how to mitigate the risks people faced. The service had robust staff recruitment practices which helped to ensure suitable staff were employed. Accidents and incident were reviewed to help reduce the likelihood of similar incidents occurring again.
The provider sought the views of people, relatives and staff on the running of the service. There was a clear management structure in place and staff told us there was a positive working culture at the service. The provider worked with other agencies to develop best practice.
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 was good (published 14 May 2018).
Why we inspected
We received concerns in relation to the management of medicines and staff punctuality. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for ASK Care Limited on our website at www.cqc.org.uk.
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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to staff punctuality, the management of medicines and the effectiveness of quality assurance and monitoring systems 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 for 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 to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
This service is a domiciliary care agency. It provides personal care to over 350 people living in their own houses and flats in the community. It provides a service to older adults, younger disabled adults and children mainly in the London boroughs of Redbridge, Newham and Havering.
Not everyone using ASK Care receives regulated activity; CQC only inspects the services provided to people receiving '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 the inspection there was a registered manager in place. 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 told us they felt safe. We found medicines were managed safely. Staff were aware of the processes in place to ensure people were protected from harm.
Staff had attended relevant training and received annual appraisals and regular supervision as required. They were aware of the Mental Capacity Act 2005 and how they applied it in practice to ensure no unnecessary restrictions were placed on people.
Care plans were person centred and reviewed regularly to ensure they reflected people’s views, values and preferences. Where required people were supported to be comfortable during the last day of their lives.
There were robust recruitment practices in place. There were enough staff employed to ensure people received care safely.
People were supported to maintain a balanced diet that met their individual preferences.
People told us they were treated with dignity and respect by staff that were polite and caring. They told us they could make complaints and that the service responded and tried to resolve any issues raised.
There were effective quality assurance systems in place to ensure the quality of care delivered was monitored and improved. People and staff thought the service was well run with the exception of a few people who thought the communication from office staff could be improved.
ASK Care Limited provides personal care to over 200 people living in their homes living in the London boroughs of Redbridge, Havering, Newham and Waltham forest and some areas of west essex . It offers a reablement service and has a mixture of CCG funded, self-funded, Direct Payments and local authority funded care packages.
The registered manager was present during our visit. ‘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 told us they felt safe and trusted the staff who cared for them. They told us that they were kept informed if staff were running late and were able to reschedule visits to suit their needs.
Medicines were managed safely by staff who had been assessed as competent.
Comprehensive risk assessments for people and their environment were completed and updated as people’s condition changed in order to ensure staff were aware of how to mitigate all assessed risks. For people who were taken out into the community separate assessments were completed to ensure appropriate action was taken during travel and in public areas.
Staff were trained on safeguarding and could explain how they would report any allegations or witnessed abuse. They knew where to find the policy and told us they would follow up any actions with the registered manager and clearly document the incident.
Staff were aware of the incident and accident reporting procedure and could demonstrate any learning from past incidents. They were aware of the procedure to take in an emergency and told us they would stay with the person until an ambulance turned up. They were all aware of the need to keep key safe numbers secure and separate from peoples.
There were recruitment processes in place to ensure that only staff deemed as suitable to work in a social care environment were employed. We noted that the provider had only just started to refresh disclosure and barring service checks for staff who had been employed for over five years. Annual appraisals and regular supervision and spot checks were completed to ensure staff followed appropriate procedure to deliver safe care.
Although annual training was offered and an opportunity for professional development by encouraging staff to gain a social care qualification, people and their relatives complained about the limited understanding of English language of some staff. In addition we noted that training for essential topics such as Mental Capacity Act (MCA) and first aid was out of date. We recommend further training for staff identified as unable to communicate effectively and a more proactive approach to arrange training for before it expired.
Care was assessed before people started to use the service and reassessed every six months or as peoples conditions changed. Care plans included people’s likes and dislikes.
People told us staff were polite and caring and treated them with dignity and respect. They told us the service was flexible and they could request the same staff to assist them on a regular basis. People said they were aware of the complaint procedure and felt that concerns were listened to and acted upon by the registered manager and the director.
Staff were aware of the Mental Capacity Act (MCA) and how it applied in their daily practice. They told us they would always seek people’s consent before assisting them.
People and their relatives told us there was an open and honest culture as management was approachable and listened to people’s concerns and complaints. There was regular quality assurance ensure people’s views were listened to. The service had a strong links with the community and offered a free recreational service to women in the community every Monday.
The staff were trained to safeguard people and there were policies in place for both the safeguarding of adults and children. People told us that they felt safe with the provider. They told us that the staff knew what they were doing and they were able to raise concerns with the manager, if needed.
The staff had mandatory training on a range of subjects and had additional annual training. They had regular supervision and an annual appraisal. One member of staff told us, "They are a good and supportive employer."
The provider sought the views of people regularly and we saw that they acted on comments received. They dealt with incidents and complaints in line with their policies. One person told us, "They are very good. If I am not happy, they would even change the carer."
We found that the service carried out checks on people before they started work, including Criminal Records Bureau checks and obtaining proof of identification. People told us they were happy with the staff. One person said "they are very professional" while a relative told us "my mum is very comfortable with them." We saw that staff had regular training, including on safeguarding vulnerable adults and moving and handling. The service had a suitable complaints procedure in place, and people told us they knew how to make a complaint if they wanted to.