A & A Services West Midlands

Updated 16 November 2023

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 carried out by 2 inspectors and an Expert by Experience, who made telephone calls to people and their relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had recently been appointed and had submitted an application to register.

Notice of inspection

We gave the service 18 hours' notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 27 September 2023 and finished on 29 September 2023. We visited the location's office on 27 September 2023.

What we did before the inspection

We reviewed information we had received about the service since our last inspection, including notifications the provider had sent to us, information from the local authority and the public. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with 3 people and 4 relatives. We also spoke with the nominated individual, the manager and 5 care staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We looked at the care records for 7 people. We checked the care people received matched the information in their records. We looked at records relating to the management of the service, including audits carried out within the service and recruitment records.

Updated 16 November 2023

About the service

A & A Services West Midlands provides personal care to people, inducing older people living in their own homes. There were 11 people using the service at the time of our inspection.

People's experience of using this service and what we found

People were not always protected from potential abuse as incidents of potential abuse had not always been recognised and procedures were not always followed. When incidents had been recorded these were not always appropriately investigated or reported. There were no systems in place to monitor the care people received, this included monitoring care records, medicines and call times. There was a lack of oversight in the service that left people at risk of potential harm and information was therefore not sought to make improvements where needed. Lessons were not consistently being learnt.

Complaints were not always responded to in line with the providers policy. Staff were not always safely recruited to ensure their suitability to work with people. There were no systems in place to ensure staff had the skills and training to support people.

When people’s care had been assessed plans were in place for staff to follow. Further improvements were needed to ensure these covered health conditions.

Support with meals was offered when needed. Staff were kind and caring towards people and they felt safe, they were left comfortable after visits.

Referrals or appointments were made on behalf of people when they needed support with their health.

There were infection control procedures in place, and they were followed. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service support this practice.

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 14 September 2022, and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about the care people received and the records that were in place, how staff were recruited and the culture of the service. A decision was made for us to inspect and examine those risks.

You can see what action we have asked the provider to take at the end of this full report.

We found no evidence during this inspection that people were harmed from the concerns we identified. However there was an increased risk of harm as people were not always protected from potential abuse. Please see the safe, effective, caring, responsive and well-led sections of this full report.

Enforcement

We have identified breaches in relation to how complaints were dealt with, how staff were recruited and how people were protected from potential abuse. We also found concerns with how the service was governed and the systems in place to monitor the care people received.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.