Background to this inspection
Updated
19 December 2019
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 Care Act 2014.
Inspection team
This consisted of one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes. 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.
The service had a manager registered with the Care Quality Commission. 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.
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 the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 10 October 2019 and ended on 30 October 2019. We visited the office location on 10 October 2019.
What we did before the inspection
We reviewed the information the CQC held about the service. This included notifications of significant incidents reported to the CQC and the previous inspection report. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with the registered manager and the quality assurance manager. We spoke with two people who used the service and five relatives or representatives. We spoke with three care workers. We received feedback from the local authority commissioning and safeguarding teams. We reviewed a range of records, including five people’s care files. We looked at two staff files and various records relating to the running of the service, including quality assurance documents and incident records.
After the inspection
We reviewed policies and procedures. We reviewed rotas, timesheets and visit records. We continued to seek clarification from the provider to validate evidence found.
Updated
19 December 2019
About the service
Anjel Direct (Recruitment) Solutions Ltd is a domiciliary care service. It provides care to people living in their own homes. At the time of our inspection they were supporting 23 people.
Anjel Direct (Recruitment) Solutions supports younger and older people with a range of needs including physical disabilities, learning disabilities and dementia.
People’s experience of using this service
Risk assessments and care plans were not always present or completed correctly. Moving and handling risk assessments were not completed in detail. The service did not adequately assess people’s risks around medicines and instructions in care plans were unclear or misleading. This put people at increased risk of harm. The service had failed to make the required improvements in this area following the last inspection.
Staff were not always recruited safely. The service had failed to make the required improvements in this area following the last inspection.
People told us they usually had continuity of care from reliable staff. However, accurate timesheets were not being kept.
People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
Consent had not always been sought in line with the regulations. The service had failed to make the required improvements in this area following the last inspection.
Most people were satisfied or pleased with the care they were receiving, and some spoke highly of individual care workers.
Staff were aware of the signs of abuse and knew how to report any concerns. People and their relatives told us they knew how to complain.
Staff told us the registered manager was supportive, and he spent a lot of time supporting people. However, being less present in the office meant that he was less effective in his oversight of the service.
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 requires improvement (published 29 November 2018). The provider did not complete an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches in relation to keeping people safe, assessing and managing risk, gaining consent for care, assessing people's needs and the good governance of the service 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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.