Background to this inspection
Updated
15 January 2021
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 Care Act 2014.
Inspection team
This inspection was carried out by two inspectors.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own home.
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.
Notice of inspection
This inspection was announced. We gave the service 48 hours’ notice of the inspection and provided an explanation as to the inspection process, and to assure ourselves effective implementation of COVID-19 guidance when visiting the office.
The inspection activity started on 16 December 2020 and ended on 18 December 2020. We visited the office on 17 December 2020.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authorities. We used all this information to plan our 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.
During the inspection
We spoke with seven people who used the service and seven relatives about their experience of the care provided. We spoke with six members of staff including the nominated individual, registered manager and care workers. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data, policies and procedures, and quality assurance records. We sought additional clarification in response to the information we had reviewed and feedback received from people and their family members. We also spoke with the brokerage team at the local authority responsible for commissioning packages of care.
Updated
15 January 2021
About the service
A&R Guardian Services Limited is a domiciliary care service. The service provides care and support to people living in their own homes. At the time of the inspection there were 40 people 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 considers any wider social care provided.
People’s experience of using this service and what we found
People and relatives told us they would recommend the service to others. People were supported by sufficient numbers of reliable staff to meet their needs. This contributed towards them feeling safe.
Risks to people had been assessed including the environment in which they were cared for. People’s care plans had been personalised, provided clear guidance for staff to promote their safety and were kept under review. People were supported with their medicines safely whilst promoting maximum choice and control of their lives.
Staff recruitment processes had been strengthened. Staff training had been updated in relation to promoting people’s safety and wellbeing and the infection prevention and control procedures.
The provider’s business continuity plan had been updated in response to the COVID-19 pandemic and had adopted the government guidance to operate a safe service. Staff were trained in the correct use of personal protective equipment (PPE). People were informed about the actions being taken and their individual needs had been considered and kept under review.
The provider had made improvements to the quality assurance systems and processes. The changes to the managerial structure provided clearer responsibilities to monitor the quality of service and to drive improvements. People’s views about their care and the service were sought in a variety of ways. Systems were in place to monitor people’s care, staff performance and safety including incidents, accidents and complaints so action could be taken. The provider had invested in electronic call monitoring system and care planning, accessible to staff using their hand held devices and provided real-time monitoring.
People spoke positively about the registered manager who they found to be responsive, supportive and approachable. The registered manager and provider were aware of their responsibilities in meeting their legal obligations. They worked in partnership with health care professionals and local authorities responsible for monitoring people’s packages of care.
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 requires improvement (published 26 March 2020).
We carried out an announced comprehensive inspection of this service on 17 February 2020. A breach of legal requirement was found. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We undertook this focused inspection to check improvements had been made and that they now met the legal requirements. This report only covers our findings in relation to the Key Questions of Safe and Well-led which contained the requirements.
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 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 A&R Guardian Services Limited on our website at www.cqc.org.uk.
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.