Archived: ANA Islington

Updated 25 October 2019

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 Care Act 2014.

Inspection team

This inspection was carried out by one inspector, and one 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.

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.

The service had a manager registered with the Care Quality Commission. 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. The service had a new registered manager who had worked at the service in a different role for approximately eight years. They registered with the Commission in June 2019.

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.

What we did before the inspection

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 reviewed information we had received about the service since the last inspection. We emailed care staff employed by the service. We received

feedback from five of them. We spoke with two people who used the service and 13 relatives. We used all of this information to plan our inspection.

During the inspection

We spoke with the registered manager, the training and recruitment manager and the nominated individual who was also the agency's owner. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

During the inspection we reviewed five people's care records, which included care plans, risk assessments and Medicines Administration Records (MRS). We also looked at four staff files, complaints and quality monitoring and audit information.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two professionals who regularly visit the service. We also contacted a number of health and social care professionals who worked regularly with the agency. We received feedback from two of them.

Updated 25 October 2019

About the service

ANA Islington is a is a domiciliary care agency. It provides personal and nursing care to people living in their own houses and flats in the community and specialist housing. It provides a service to adults of all ages that required support and care due to deteriorating health. At the time of our inspection there were 19 people who received personal care from the agency.

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

The provider had made improvements to how they managed people’s medicines. However additional improvements were needed. This was to ensure medicines administration charts (MARs) only reflected medicines currently taken by people and that when people did not take their medicines this was reflected consistently by staff on MARs.

There were systems in place to protect people from harm and abuse. People and relatives said they felt safe with staff visiting them. Risks to people’s health and wellbeing had been assessed. Staff were recruited safely to ensure only suitable staff supported people. The same staff usually visited people and there were sufficient staff deployed to ensure visits took place as planned. Accidents and incidents had been reported, recorded and analysed so lessons could be learnt so that the accidents and incidents did not to reoccur.

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 supported this practice. Staff asked people’s consent before providing care and support to them.

People’s needs had been assessed regularly and any changes had been reflected in their care plans. Staff were supported through training, regular supervision, spot checks of their direct work with people and yearly appraisal of their performance. People were supported to have diet that met their nutritional needs and personal preferences. Staff supported people to have access to health professionals when people’s needs had changed or their health deteriorated.

Staff treated people with kindness and they respected equality and diversity amongst people they supported. The same staff usually visited people and therefore they knew people’s needs and preferences well. Staff encouraged people to express their views and be involved in making decisions about their care. People and relatives said they felt their dignity and privacy was respected by staff who visited them.

Care plans were holistic and personalised. They provided staff with clear information on what support was needed, who and what was important to people and what their interests and hobbies were. Staff knew how to communicate with people so people understood and could respond. When possible, people’s families had been encouraged to participate in planning and reviewing of care for their relatives.

Overall people and relatives were happy with the care provided. They knew who managers were and they thought overall sufficient action was taken to address complaints and concerns raised by people and relatives.

The provider had a range of checks in place to ensure care provided to people matched their needs and that staff had skills to do it safely. There was a clear leadership structure in place and staff were provided with information on what their role was and what was expected from them. Most staff said they could contact the office any time for support when needed. Staff, people and relatives were encouraged to provide feedback about the service provision. The management team were responsive to feedback received and they were proactive in addressing issues identified.

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 13 October 2018) and there were breaches of regulation 12 related to management of medicines and assessing risk to health and wellbeing of people who used the service. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.