Always Here Limited

Updated 20 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

The 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 homes.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with CQC 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 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 16 February and ended on 01 April 2022. We visited the office on 17 February 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 professionals who work with the service. We used the information the provider sent us in the provider information return. 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. We used all this information to plan our inspection.

During the inspection

We spoke with one person that used the service and five relatives about their experiences of the care provided. We spoke with 13 staff including the registered manager, deputy manager, care coordinator and care workers.

We reviewed a range of records. This included four people’s care records and three medication records. We looked at three staff files in relation to their recruitment and supervision. A variety of records relating to the management of the service, including policies and procedures and training information were viewed.

Updated 20 May 2022

About the service

Always Here Limited is a domiciliary care service providing personal care to older people, younger adults and people living with dementia, sensory impairment or physical disability. The service was supporting 27 people at the time of our inspection.

Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

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

People were at risk due to poor governance and record keeping at the service. The provider did not understand regulatory requirements and had not met these. Their quality assurance systems were not effective or robust in identifying shortfalls. Staff were committed to providing good quality care and had started to make improvements following our inspection.

People were at risk of harm as risks to their safety and medicines were not always managed effectively. We could not be sure that people had received their medicines as prescribed.

People were supported by staff that had not always received the necessary training and competency checks to enable them to perform their role. Despite this, people and their relatives felt safe with staff and told us they received support from regular staff that were familiar with their needs.

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 good (published 13 June 2018).

Why we inspected

We received concerns in relation the management of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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 good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Always Here 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 will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment, good governance, staffing, fit and proper persons employed and statutory notifications at this inspection.

Please see the action we have told the provider to take at the end 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.