13 March 2018
During a routine inspection
This was the first inspection of this service since they registered with the Care Quality Commission (CQC).
This service is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to people with varying levels of need, including older people, people living with dementia and mental health, physical disability and sensory impairment.
There was a registered manager at this service. 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.
Angelica Care Limited provides personal care services to people living in the Bognor Regis and Chichester areas. Companionship and domestic support can also be provided. Not everyone using Angelica Care Limited received regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection, 36 people were receiving personal care services from the agency.
People received a safe service and were protected from the risks of abuse. Staff received appropriate training and knew how to raise concerns if they felt people were at risk of being abused or mistreated.
People’s individual needs and any identified risks to them and staff were assessed and managed effectively. People who were living with disability that made communication difficult for them were supported to communicate effectively by staff. Various communication aids were used, which included large print records, picture boards and staff were able to adapt their communication style to suit people’s needs accordingly, such as asking simpler questions for those who may be living with cognitive difficulties. People were involved in the planning and review of their care. Medicines were given safely to people with medicines prescribed on an ‘As required’ (PRN) basis being given when people needed them. Staff used appropriate protective equipment such as gloves and aprons which kept people safe from the risks of infection.
There were enough staff to meet the needs of people. Technology was used effectively to schedule visits to people in their homes. The electronic system was also used to monitor actions taken by the agency in relation to the care of people which ensured that the service provided to people was monitored closely. This system also enabled the registered manager to observe the safety and whereabouts of staff while lone working.
People received care from staff who had undertaken training to be able to meet their individual needs and preferences, which included having enough to eat and drink. Staff were recruited safely. Checks were completed by senior staff which ensured staff performance and competence was closely monitored. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive ways possible. The policies and systems in the service supported this practice.
People told us that staff were caring and kind in their approach and that staff treated them with dignity and respect. Staff were aware of how to protect people’s privacy which ensured this was maintained. At times staff provided support to people that we were told was above and beyond the expectations of a healthcare professional.
Systems and processes were used effectively to monitor the quality and safety of the service. People and their relatives knew how to make a complaint should they need to. Complaints were addressed and handled appropriately and promptly to the satisfaction of the complainant.
At the time of this inspection the agency weren’t actively supporting people at the end of their lives. However, the office manager had received training from a local hospice regarding effective end of life care for people and the registered manager was able to tell us how they would support people and their families to receive personalised end of life care using advance care planning. We spoke with a healthcare professional who provided a very positive example of how the registered manager had gone above and beyond to support a person and their family at the end of their lives. Appropriate documentation was seen for those people who did not wish to be resuscitated which ensured that people received the end of life care they wanted or that was required in their best interests.
The service was well-led, with a clear management structure and open, friendly culture among the staff working for the agency.