Background to this inspection
Updated
22 July 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on the 31 May and 2 June 2016 and it was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service; we needed to be sure that someone would be in.
The inspection was carried out by one inspector and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert-by-experience has experience of dementia care, domiciliary services and other care environments.
Before the inspection, we examined the information that we held about the service and the service provider. Prior to the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the Provider Information Return (PIR) and other information we held about the service. This included statutory notifications sent to us by the registered manager about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send to us by law. We used all this information to decide which areas to focus on during our inspection.
On the day of the inspection we visited one person in their home and observed how they were supported by staff. We looked at their home care file. We spoke to them about their views of the care they received. We visited the registered office where we met with the registered manager. We looked at three care records, medication administration records (MAR), complaints, accidents and incidents record, surveys and other records relating to the management of the service. We met with a community team supervisor and two care staff separately and looked at four staff records. This included staff recruitment documents, training, supervisions and appraisals. The expert-by-experience spoke with seven people and three relatives by telephone to gain their views of the service and care they received.
The service was last inspected in December 2013 where there were no concerns.
Updated
22 July 2016
This inspection took place on the 31 May and the 2 June 2016 and it was announced.
Abicare Services Limited - West Sussex is a domiciliary care service providing support to people in their own homes. The service supports older people, people living with dementia, people with a physical disability, people with mental health needs, those with a sensory impairment and younger adults. At the time of our visit, they were supporting 52 people with personal care.
The service had a registered manager who had been in post since August 2015. 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 spoke positively about the support they received from care staff but also shared frustrations over staff not arriving at the preferred or agreed times, not knowing in advance which staff were attending and a lack of contact from the office when this happened. People and the service confirmed the agency was short staffed therefore this impacted on the deployment of staff and how care visits were carried out.
Medicines were not always managed safely. Significant gaps and a lack of guidance for staff were noted within care records. The records in place did not demonstrate that people had received their medicines as prescribed.
People had been asked their views of the service. People told us they knew who to go to to make a complaint and how they would do so if required. Some people told us complaints were made yet no action was taken to resolve the complaint. Complaints were recorded although it was not clear what the outcomes were what actions had been taken and what learning had been achieved to improve the service.
The service had quality assurance monitoring tools in place to identify areas which required improvement however this had not always been used effectively to implement the necessary changes in a timely way. Shortly after the inspection an action plan was provided which showed how improvements to the service were to be made.
Staff had been trained in how to recognise signs of potential abuse and protect people from harm. Risks to people had been identified and assessed and information was provided to staff on how to care for people safely and mitigate any risks.
Staff spoke kindly and respectfully to people, involving them with the care provided. Staff had developed meaningful relationships with people they supported. Staff knew people well; they promoted people’s privacy and dignity and had a caring approach.
Staff implemented the training they received in core subject areas by providing care that met the needs of the people they supported. Staff received regular supervisions and spoke positively about the guidance they received from the registered manager and other members of the management team.
People were encouraged to be as independent as possible and to be involved with determining the care they received. Staff understood the requirements under the Mental Capacity Act 2005 and about people’s capacity to make decisions. People received personalised care. People’s care had been planned and individual care plans were in place. They contained information about people’s lives, including their personal histories.
We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of the report.