Apple Homecare Limited

Updated 17 May 2022

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

Consisted of one inspector. A second inspector supported with the completion of telephone calls to people and their relatives.

Service and service type

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

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

We gave a period notice for the inspection because we needed to be sure that the provider or registered manager would be in the office to support the inspection process.

Inspection activity started on 04 March 2022 and ended on 23 March 2022. We visited the location’s office on 09 March 2022.

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 authority, and we reviewed the action plans the provider had been sending to us as an outcome of enforcement action taken following the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

During the inspection

We spoke with the registered manager, quality lead, care supervisor and members of the management team. We sourced feedback from six members of care staff by email. We reviewed seven people’s care records and three people’s medicine administration records, as well as other people’s records relating to the administration of topical medicines for the care of their skin. We looked at staff files in relation to recruitment and staff supervision. We reviewed a variety of records relating to the management of the service, including policies and procedures. We spoke with four people who use the service and five relatives.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 17 May 2022

About the service

Apple Homecare Limited provides domiciliary care services to people living in their own homes. At the time of the inspection, the service provided care and support to 39 people who were receiving a regulated activity of ‘personal care.’ CQC only inspects where people receive the regulated activity of personal care. This is help with tasks related to personal hygiene and eating. Not everyone who used the service received personal care. Where they do, we also consider any wider social care provided.

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

We received consistently positive feedback from people using the service and their relatives. They told us they felt staff were respectful of working in their home, and treated them as individuals, with kindness and care. People told us they looked forward to the staff visiting, as they enjoyed a laugh and a joke which put them at ease, particularly when receiving personal care.

People told us that staff supported them as required with their medicines, applying creams to their skin, and with managing their nutritional and hydration needs. Relatives told us they felt confident with the consistent standards of care being provided by staff, to maintain people’s safety and independence in their own homes. People and their relatives told us the staff arrived at their care visits on time, stayed for the agreed length of time and would let them know if they were running late.

People and their relatives told us staff wore the required personal protective equipment and disposed of this correctly, to keep them safe and protect them from the risks of catching infections, including COVID-19. 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.

People and their relatives told us that their views and feedback were regularly sourced by the registered manager, and felt able to contact the office team as required. A relative said, “There is nothing to change, the staff make [Name] laugh and care for them how they like, they [the staff] are a great bunch of people and they give their all while they are there.”

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 Inadequate with breaches of regulation (published 29 February 2021). Following on from the last inspection, the provider completed an action plan to show what they would do and by when to improve. Enforcement action was also taken as an outcome of the last inspection.

At this inspection, whilst we found improvements had been made the provider remained in breach of regulation 17 (good governance).

This service has been in Special Measures since July 2021. During this inspection the provider demonstrated that improvements continue to be made. The service is no longer rated as Inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. As an outcome of the last inspection, conditions were imposed on the provider’s registration relating to breaches of regulation 11 (consent), 17 (good governance), 18 (staffing), 19 (fit and proper persons employed). A warning notice was served in relation to breaches of regulation 12 (safe care and treatment).

We undertook this focused inspection to check the provider had addressed the previous breaches of regulation and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Inadequate 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 Apple Homecare Limited on our website at www.cqc.org.uk.

Enforcement and Recommendations

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 have identified a continued breach of regulation in relation to good governance (regulation 17) at this inspection.

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 continue to monitor information we receive about the service, which will help inform when we next inspect.