Archived: Apex Prime Care - Highcliffe

Updated 14 September 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

The inspection took place on 29 and 31 August 2018 and was announced. The provider was given 24 hours’ notice. This was so that we could be sure the registered manager was available when we visited and that consent could be sought from people to receive home visits from the inspector.

The inspection was carried out by one inspector on both days. Phone calls to people were completed by an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. They had experience in dementia care and care at home services. We visited the office location on the first and second day to see the registered manager and to review care records and policies and procedures.

Before the inspection we reviewed all the information we held about the service. This included notifications the service had sent us. A notification is the means by which providers tell us important information that affects the running of the service and the care people receive. we also contacted social care commissioners to gather feedback about their experience of the service.

We had asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This information was reviewed prior to the inspection.

We visited two people and discussed their experience of the service. We had telephone conversations with three people and six relatives.

We spoke with the registered manager, administrator and four members of the care team.

We reviewed five people’s care files, medicine records, three staff files, minutes of meetings, complaints and audits.

We asked the registered manager to send us information after the visit. This included a completed communication assessment and a reviewed best interest decision for a person. This was sent to us on 3 September 2018 as agreed.

Updated 14 September 2018

The inspection took place on the 29 and 31 August 2018 and was unannounced. This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults. At the time of our inspection there were 51 people receiving a service from the agency.

The service has a registered manager. 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.

People felt safe and were supported by staff who understood how to recognise and report suspected abuse. People’s risks were understood and actions were in place to minimise risks of avoidable harm including the risk of preventable infections. People received their medicines safely and staff understood the actions needed if an error occurred. Staff had been recruited safely including checks to ensure they were suitable to work with vulnerable adults. Staffing levels provided flexibility in meeting people’s changing needs and included office staff carrying out care duties and staff supporting from a neighbouring Apex Prime Care branch. When things had gone wrong lessons were learnt and shared to improve learning and improve outcomes for people.

Assessments had been completed with people to gather information about their care needs and lifestyle choices. People had their eating and drinking requirements met as staff understood people’s likes, dislikes and any barriers to eating a well-balanced diet. Assessments included any need of technology such as alarm pendants and these were then included in care plans for regular testing. Staff received an induction and ongoing training and support that enabled them to carry out their roles effectively. Working links had been developed with other professionals such as district nurses and occupational therapists which meant more effective health and welfare outcomes for people. People were supported with access to healthcare for both planned and emergency situations.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. A complaints process was in place and people felt if they raised concerns they would be listened to and actions taken. There had been no formal complaints since our last inspection.

People spoke positively about the care team describing them as kind, patient and caring. One person described how, when they felt low in mood, staff understood and, through encouragement, helped them feel better. People felt involved in decisions about their care including the care staff that visited them in their homes. People were treated with respect and dignity and described staff as supportive with helping them maintain their independence.

People had person centred care plans which reflected people’s diversity and were understood by the staff team. Reviews took place at least six monthly with people and, if appropriate, their families. When changes in people’s care needs were identified actions were taken to ensure the care provided reflected the person’s changing needs and choices. Links with the community had been made which provided additional social support for people such as a dog walking befriending service. Assessments had been completed detailing people’s individual communication preferences and these were understood by the staff team. People had an opportunity to be involved in end of life care plans which included a monthly review of any ‘do not attempt resuscitation’ decisions.

People, their families and staff described the office as well organised and always available when contacted. Staff understood their roles and responsibilities, felt communication was effective and felt listened to and appreciated by the management team. The registered manager understood their legal obligations for sharing information with CQC and safeguarding. Opportunities for engagement with people were available through meetings, newsletters and fund raising events.

Auditing and monitoring tools had been reviewed since our last inspection and were more effective in monitoring service delivery and areas of improvement. Face to face reviews with people and their families were used as an opportunity to gather feedback on the service. Some people had commented that they would like more consistency in the care staff visiting them. This was being addressed through recruitment of new staff.