Archived: Apollo Care South Liverpool Also known as T/A CareCaliRaya Ltd

Apollo Care South Liverpool is a domiciliary care service that provides personal care to people in their own homes. 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. The service was supporting 41 people at the time of the inspection.

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

Some aspects of managers roles and regulatory requirements had not been met. Prior to the inspection we had been concerned about the outcome of a safeguarding investigation conducted by the Local Authority. This raised issues around the effective management and running of the agency. We asked the provider to investigate, however the report produced raised issues around the thoroughness and impartiality of the investigation. The providers policy used for carrying out the investigation needed review and updating.

Other regulatory requirements were not always complied with. We identified statutory notifications should have been submitted to CQC as a measure of monitoring the quality and safety of care people received.

Staff spoken with displayed an understanding of safeguarding principles and reporting. However, we found safeguarding recommendations made after one [initial] investigation had not been followed by the provider, which may have caused potential risk for one person and staff.

The registered manager and nominated individual advised us that, as part of ongoing review and lessons learnt, they are reviewing the management and running of the service and would advise us of changes to be made.

People reported good support regarding the management of their medicines and told us they got their medicines on time. The medications records reviewed supported best practice. Staff administering medicines were suitably trained and competent.

We found ongoing checks of people’s home environment helped ensure people were safe. Risks associated with people’s care were mostly identified and managed to minimise harm. Supporting care records identified most key risks and there were plans in place to help keep people safe.

The service was staffed appropriately at the time of the inspection. Staff employed had been recruited safely and most had worked for some time for Apollo Care South Liverpool. This helped to maintain a consistency of care for people.

People's experience of using the service was positive. People received the care and support they needed when required. The feedback we received showed staff were helpful and kind and treated people with dignity and respect. One person commented, “Yes definitely [I feel safe]. Carers always act appropriately and are very friendly.”

Rating at last inspection

The last rating for this service was Good (published 8 January 2020).

Why we inspected

The inspection was instigated following background concerns regarding a safeguarding investigation and outcome. This raised issues around the running of the agency and ongoing safe standards. The Commission is aware that the provider disputes the content of the local authority safeguarding investigation.

A decision was made for us to inspect and examine those risks. We undertook a focused inspection to review the key questions of safe and well-led only.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed to Requires improvement. 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 Apollo Care South Liverpool 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 monitor the service.

We have identified a breach of regulation as the provider had not met some regulatory requirements in the governance and running of the service.

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.

Apollo Care South Liverpool is a domiciliary care service that provides personal care to people in their own homes. 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. Apollo Care provides services to a wide range of people including those living with a learning disability and/or autism.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good for the safe, effective, caring and well-led domains. There has been a change of rating to Outstanding for the responsive domain.

The philosophy of the service valued the uniqueness of every individual and promoted the provision of care and support as individual as the person receiving it. Management were passionate about providing high-quality person-centred and dignified support for people, and empowering people to have a say in the care and support they wanted. This vision was widely shared by staff.

People using the service benefitted from tailor made care which was truly unique to them. The service took the time to get to know about what was important to people. Staff were pivotal in the delivery of individualised care and support, and supported people to be a part of both their local and wider community.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

People were supported in such a way that allowed them 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.

People received care and support from staff who were genuinely caring and compassionate and who were familiar to them. Staff had not only formed strong relationships with the people they supported, but also their relatives.

Staff provided care and support in a dignified way and with consideration. Staff took care to encourage and maintain people’s independence as far as possible.

The service provided support to people at the end stages of their life. People were treated in accordance with their wishes, with dignity and with the utmost respect.

Feedback about the management of the service from people, their relatives and staff was positive. The registered manager adopted a hands-on approach to the deliverance of care and support.

Staff were well supported in their role with appropriate training and supervision. Staff had also received additional training to meet the specific needs of the people they were caring for.

Regular checks and audits were carried out to determine the quality and safety of the care and support being provided. Risk to people was appropriately assessed and measures were put in place to support people safely, whilst still respecting their freedom.

The registered manager and registered provider had met their legal requirements with the Care Quality Commission (CQC). They promoted person centred care and transparency within the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

At our last inspection, the service was rated "Good." (Report published June 2017).

Why we inspected

This was a planned inspection based on the rating of the last inspection.

Follow up

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

Apollo Care South Liverpool is a family run organisation which provided support for 15 people living in their own homes in the geographical area of South Liverpool. The regulated activity of personal care was provided for seven people. On the first day we visited the organisation’s office; on the second day we visited three people in their homes who were happy to speak with us about the care they received. We also spoke with one person on the phone. This was the first inspection of this service.

The organisation required and had a registered manager. 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 thought the staff at Apollo Care South Liverpool were caring. One person said, “To some people it’s just a job, but with these staff, it’s genuine. They seem to make an effort to assist and it makes a difference”. People’s relatives we spoke with told us they thought the service was caring. One relative said, “I have never met such caring people”. People told us that they felt listened to by the organisation. One person said, “I’ve been supported to have a voice in my life, they have helped me to stay independent”.

Staff told us they were happy in their roles. One staff member commented, “It’s a very caring company. People here have really nice relationships”. We saw and people told us, that staff treated them with dignity and respect in their own homes. We also saw that people’s personal information was treated with respect and kept in confidence. The service operated within the principles of the Mental Capacity Act (2005). People told us they were treated with respect and their consent to their care was sought.

People told us that they felt safe with the support they received. Their relatives told us that the service was reliable and that they had confidence in the service. One person’s relative said, “They make us feel at ease”. We saw that appropriate risk assessments were in place and a record of any accidents and incidents had been made and they had been responded to quickly. People received their medication in a safe manner.

New staff had been safely recruited. Induction of new staff included initial training and shadowing the work of more experienced staff members. Staff told us they were well supported with regular supervision meetings, feedback from spot checks and training. Staff agreed that they were well supported by the organisation. One staff member said, “It’s a very friendly company to work for, they are really approachable”.

Staff had received training in, and were familiar with, their responsibilities in safeguarding vulnerable adults.

People told us that the service was responsive to their needs and they received support from staff who were familiar to them. We saw that people had person centred care plans, which were clear, individualised and were positive about people and what they were able to do. The care plans outlined what tasks people wished help or support with along with a personal assessment of their support needs. We saw that people were supported with any health needs they may have and the organisation liaised with health professionals.

People told us that their care plans reflected the care they received and we saw that people’s care plans were reviewed regularly involving the person and their family members if appropriate.

We found the registered manager and director to be open and candid and it was clear during the visits made that they were well known to and had positive relationships with people cared for and their families. People told us that they were responsive and flexible. The registered manager told us, “When somebody asks us to do something, if we can, we will”.

We saw records in people’s care files and people told us that the registered manager made regular visits to people. Recently when new staff had been recruited the registered manager told us that he liked to personally introduce them to the people who use their services. The registered manager used these frequent visits along with some audits and checks to ensure that people received a service of a high quality.