Assured Care Formby

Updated 1 March 2024

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 2 inspectors.

Service and service type

This service is a domiciliary care agency. It provides personal care to people 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 a registered manager in post. There was also a manager at the service who assisted the registered manager (who was also the registered provider) with the everyday running of the service. There were plans for the manager to take over the registered manager’s role in the near future.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure that the provider or manager would be in the office to support the inspection.

Inspection activity started on 11 January 2024 and ended on 26 January 2024. We visited the office location on 11 January 2024.

What we did before inspection

We reviewed information we had received about the service since registration. 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 4 people who used the service about their experience of the care provided and 1 relative. We spoke with 6 members of staff including the registered manager, manager, care co-ordinator and 3 members of care staff. We reviewed a range of records. This included 9 people's care records and multiple medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

Updated 1 March 2024

About the service

Assured Care Formby is a domiciliary care agency providing care to people living in their own homes, so they can live as independently as possible. At the time of our inspection the service was supporting 49 people with personal care. 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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted.

Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Right support: Some people were not 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 always support this practice.

We have made a recommendation about how the provider can work more in line with the principles of the MCA (Mental Capacity Act.)

Right care: Although people told us they received person-centred care and care which promoted their dignity, privacy and human rights, further information was required in care plans to help provide further guidance for staff, such as information about their preferences and interests. At the time of our inspection, not all staff had received specific training to aid the support of people living with autism/and or a learning disability.

Right culture: The ethos, values, attitudes and behaviours of leaders and care staff did not always ensure people using services lead confident, inclusive and empowered lives. Staff knew people well and were able to deliver person-centred care, but the oversight of the service was ineffective and inconsistent.

Medicines were not always managed in a safe way. We were not assured people had their medicines as prescribed. Staff hadn't always had their competency assessed to ensure they were able to administer medicines safely.

Oversight and governance processes did not always assure the delivery of safe and high-quality care. Some audits were not completed routinely or at all. The registered manager had failed to fully address the concerns found at the last inspection.

Information about risk was not always properly reviewed or up to date. People’s care plans required further information to manage risks effectively.

Staff were not always recruited in a safe way. References had not always been sought.

We have made a recommendation about recruitment practices.

Although people told us they received care and support which was person centred to them, care plans did not always reference best evidence guidance and lacked accurate and consistent information.

People and their relatives told us they were happy with the support they received. We also received positive feedback from staff about their experiences of working for the service. It was clear staff had formed genuine and positive relationships with the people they supported.

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

Rating at last inspection and update

The last rating for this service was requires improvement (report published 17 March 2023). The service remains rated requires improvement. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found although some improvements had been made, the provider remained in breach of some regulations.

At our last inspection we recommended that the provider sought advice and guidance from a reputable source on supporting people's communication needs and updated their practice accordingly. At this inspection we found the provider had acted on our recommendation and had added information about communication needs to people’s care plans.

Why we inspected

We carried out an announced comprehensive inspection of this service on 11 January 2024. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, consent, person centred care, staffing, fit and proper persons employed and good governance.

We undertook this comprehensive inspection to check they had followed their action plan and to confirm they now met legal requirements. We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive 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.

Enforcement and Recommendations

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

At this inspection we found the provider remained in breach of regulations 12 and 17.

We have made recommendations about the need for consent (regulation 11) and fit and proper persons employed (regulation 19).

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.