Ambition Community Healthcare

Updated 11 June 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 one inspector, a specialist advisor who was a registered nurse and 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.

Service and service type

Ambition community health care is a domiciliary care agency. It provides personal care to people, both adults and children living in their own houses and flats.

Registered Manager

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 not a registered manager in post. There was however an acting manager who told us they were applying to CQC for their registration.

Notice of inspection

We gave a short period of notice of the inspection because we wanted the manager to contact people ahead of the inspection and ask them for their consent for us to speak with them.

The Inspection activity started on 05 May 2022 and ended on 17 May 2022. We visited the location’s office on 05 May 2022.

What we did before the inspection

We reviewed all the information we had received about this service since its registration with us in 2019. We used the information the provider sent us in the provider information return (PIR). 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 two people using the service and six relatives. We spoke with the three directors, the manager, the care coordinator and three nurses. We reviewed records including two care plans and risk assessments, staff files and recruitment. We requested additional information in relation to staffing, auditing and governance.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We spoke to a further member of staff and received some collective feedback from the Clinical Commissioning Group, (CCG).

Updated 11 June 2022

About the service

Ambition Community Health Care is a domiciliary care agency based in Dereham. It provides personal care to children and adults with a range of support needs who are living in their own homes. There were 28 people using the service. Not everyone who used the service received personal care. 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

Ambition Community Health Care provides complex clinical care. The team is made up of three directors each with a lead role and one being the nominated provider. A manager, care coordinators and nurses provide bespoke packages of care. The company complete a comprehensive assessment of need. Once a package of care has been agreed a staff team are recruited to the person and trained to deliver the care. This helps to ensure people received care and support from staff who understand their needs.

The premises are accessible to people using the service and support a growing business. Multiple software systems assist them in evidencing: How they are delivering people’s care needs: Recruiting and supporting staff and how they review governance and compliance. Their goal is to have a paperless system which provides live data which can be reviewed in an ongoing way. This helps to ensure care delivery is smooth and effective.

Staff recruitment has been a big challenge; however, the post of an employment recruiter has been sourced to try and address this and help ensure there are enough staff to cover people’s needs in a flexible, ongoing way. People received their care visits at the times agreed from a regular team of staff. A number of visits had been missed either due to cancellation, staff sickness, client sickness or unavailability of staff. We are not aware of any significant impact from this but are aware of one person no longer using the service because they chose to find a different care provider. The service used a system to rate calls to ensure essential care is always delivered.

Individual risks and risks associated with people’s care were well managed. Infection prevention and control, and the safe administration of medicines were managed well and in line with legislative requirements and recognised best practice guidelines.

People received good standards of care. Care and support plans took into account people’s needs and preferences. Goals and objectives were set, and care plans were reviewed in an ongoing way to ensure the support provided remained appropriate to their needs. Staff upheld people’s privacy and dignity and were supported to develop their skills and competencies.

Staff understood the importance of gaining consent from people. People were supported to have maximum choice and control over their lives and care staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Effective systems to monitor the quality and safety of the service were in place and the provider used feedback to monitor and improve the quality of the service.

Rating at last inspection

The service was registered with us on 05/02/2019. This was their first inspection.

Why we inspected

This was a planned comprehensive inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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