Applewood Support Limited

Updated 25 October 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection Team

One inspector and an Expert by Experience carried out this inspection. The Expert by Experience had personal experience of caring for older people.

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 the quality and safety of the care provided.

Notice of inspection

We gave notice of our inspection to the provider on 4 October 2019. This was because we needed to be sure that the provider or the registered manager would be in the office to support the inspection. Inspection activity started on 4 October 2019 and ended on 7 October 2019. We visited the office location on 7 October 2019.

What we did before the inspection

We reviewed information we had received about the service since our last inspection. This included details about incidents the provider must notify us about, such as abuse. We also sought feedback from the local authority. As part of the inspection we used information the provider sent to us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used all the information to plan our inspection visit.

During the inspection

We had telephone conversations with 15 people and their relatives to gain their feedback about the service. We spoke with eight members of care staff, the human resources staff member, the finance staff member, the registered manager and the provider. We reviewed a range of paper and electronic records. This included a review of four people’s care plans, medication records, daily care notes and risk management plans. We also looked at records relating to the governance and managerial oversight of the service. These included quality assurance checks, personal data security, staff recruitment and training records.

Updated 25 October 2019

About the service

Applewood Support Limited is registered to provide personal care to people who live in their own homes. At the time of the inspection 60 people were supported by the agency. This included older people, some of whom were living with dementia and, or, specific health conditions.

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

Since our last inspection, improvements had been made to personalise care records, so staff had information about what people liked to talk about, their hobbies and interests. People and their relatives gave us positive feedback about staff being kind and caring toward them. Staff promoted people’s independence and maintained people’s privacy and dignity.

Overall, staff knew people well and how to reduce risks of harm or injury. However, risk management plans had not always been written when risks had been identified. This meant new staff or staff covering care visits did not always have important information to refer to if needed and regular staff could not refresh their knowledge of people's needs.

Staff had received training on how to protect people from the risks of abuse and understood the importance of reporting any concerns.

Staff understood how to reduce the risks of spreading infection. People had their prescribed medicines available to them and were supported with these from trained care staff.

There were sufficient staff and people received their care visits at the agreed times. The provider had a call monitoring system that created an alert if care staff were running late. When alerts were received these were acted on to ensure people received their care visit. The provider had a safe recruitment system to ensure staff’s suitability to work at the home.

People’s needs were assessed before their care visits commenced. People were supported with their food and drink where this was part of their agreed care. Staff worked within the principles of the Mental Capacity Act 2005 and understood the importance of gaining consent from people.

There were systems were in place for people and their relatives to give their feedback on the service. People felt well cared for and they, and their relatives had no complaints.

There were some quality assurance systems in place to check the safety and quality of the services. However, improvement was required to the managerial oversight through audits to ensure these were robust and identified any issues where improvements were needed.

The provider and registered manager needed to refresh their knowledge about when they were required to send statutory notifications to CQC and ensure they met their legal responsibilities.

Rating at the last inspection

The last rating for this service was Good (published 26 May 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 inspection programme. If any concerning information is received, we may inspect sooner.

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