Background to this inspection
Updated
6 July 2022
The inspection
We carried out this performance review and assessment under Section 46 of the Health and Social Care Act 2008 (the Act). We checked whether the provider was meeting the legal requirements of the regulations associated with the Act and looked at the quality of the service to provide a rating.
Unlike our standard approach to assessing performance, we did not physically visit the office of the location. This is a new approach we have introduced to reviewing and assessing performance of some care at home providers. Instead of visiting the office location we use technology such as electronic file sharing and video or phone calls to engage with people using the service and staff.
Inspection team
The inspection was carried out by one inspector with support from a pharmacy inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that a member of staff would be available to support the inspection. Inspection activity started on 19 April 2022 and ended on 23 May 2022.
What we did before the inspection
We reviewed information we held about the provider, including information we had received on how many people they were providing care to and information they had shared to demonstrate that they were providing a regulated activity.
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
We used all of this information to plan our inspection.
During the inspection
We reviewed records of care and support for two people who used the service and records of recruitment, training and supervision for three care workers. We also reviewed information relating to the management of the service such as policies and audits. We spoke with the registered manager, three relatives of people who used the service and three care workers.
This performance review and assessment was carried out without a visit to the location’s office. We used technology such as video calls to enable us to engage with people using the service and staff, and electronic file sharing to enable us to review documentation.
Updated
6 July 2022
About the service
‘Andrewjons, 7 Redan House’ is a domiciliary care agency. The service provides personal care to children with physical disabilities in their own homes. At the time of our inspection there were two people using the service.
People’s experience of using this service and what we found
People spoke of good communication with the registered manager and felt that when concerns had arisen that this would be acted on promptly. People spoke of their family members receiving appropriate support, with some care workers demonstrating strong skills and good engagement. However, sometimes the service struggled to provide consistent staff to meet the needs of people and their families.
There were suitable measures to safeguard people from abuse and staff were recruited safely. However, risks to people using the service were not always assessed and managed appropriately and in some cases risk assessments for some activities had not been completed. Moving and handling plans were quite vague and lacked detail on how exactly people could be supported to transfer safely. There were suitable processes for addressing incidents but the provider did not always log and respond to incidents appropriately to implement suitable plans to prevent a recurrence. The management of medicines was not always safe with significant discrepancies in assessments and recording.
Care workers received the right training and supervision to carry out their roles and there were systems to ensure staff had the right competency to undertake particular tasks. The service worked with other agencies such as healthcare professionals to ensure that people’s health needs were met but did not routinely integrate this information into their own care plans.
Care plans were not always person centred and lacked clear detail on how people liked to receive care and how they liked to communicate. Plans were not always updated to reflect the actual care people received day to day and were lengthy and formulaic, without always exploring what was important to people. The service worked with people’s families to review care plans but did not always use this opportunity to ensure that care plans accurately reflected people’s needs.
The registered manager worked with people’s families and staff to promote an open culture and to monitor people’s concerns and issues. Systems of audit were not sufficiently developed to ensure that people always received high quality care or to act promptly to address risks.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection:
We registered this service on 27 July 2017 and this was the first inspection. This location was dormant until November 2021. This meant that the provider was not providing personal care to people until this date and therefore could not be inspected.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement and recommendation
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 and will take further action if needed.
We have found breaches in relation to safe care and treatment, good governance and person centred care at this inspection. We have made a recommendation about how the provider meets the Accessible Information Standard (AIS).
We issued a warning notice regarding safe care and treatment. You can see what action we have told the provider to take at the back of the full version of this report.
Follow up
We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.
This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and video and phone calls to engage with people using the service as part of this performance review and assessment.