Background to this inspection
Updated
24 May 2023
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.
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 provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
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 the service is small, and we needed to be sure the registered manager would be in the office to support the inspection.
Inspection activity started on 11 April 2023 and ended on 5 May 2023. We visited the location’s office on 12 April 2023.
What we did before the inspection
We reviewed information we held about the service since they registered with the CQC. 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 (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 2 people who used the service and 5 relatives about their experience of the care provided. We spoke with 7 members of staff including the registered manager, director, care manager and care workers.
We reviewed a range of records including medication records and 7 people’s care records. We looked at 3 staff recruitment files, staff supervision documentation, along with training data. We also reviewed a variety of records relating to the management of the service, including policies and procedures used by staff as a point of reference to support them in their roles.
We reviewed documents during our visit to the office but continued to review documents via our secure electronic file sharing platform.
Updated
24 May 2023
About the service
AW House is a domiciliary care service providing personal care to people living in their own homes. The service provides support to people living with dementia, mental health, older people, younger adults, and people with physical disabilities and sensory impairment. The service also provides occasional live-in respite care for people with learning disabilities or autistic spectrum disorder. At the time of our inspection there were 28 people using the service. 1 person at the time of our inspection received live-in care support.
People’s experience of using this service and what we found
Governance checks to monitor and improve the quality of the service and maintain compliance with regulation were not always implemented effectively. The registered manager had followed up on safeguarding concerns with people and their relatives and had put the necessary preventative measures in place to resolve concerns but had failed to notify both the CQC and local authority.
People were supported to have a maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. This support was based on input from family during the initial care needs assessment. Mental capacity assessments had been completed by the registered manager with family members, but best interest decisions documentation had not been put in place.
The registered manager acknowledged the missing best interest records and took immediate steps to obtain the relevant information and retrospectively notify both the CQC and local authority.
People felt safe with the care and support provided by the service. All staff had received safeguarding training and knew how to protect people from harm. Safeguarding policies and processes were in place.
Risks to people were reviewed regularly with people and their relatives. Professional health and social care support was called upon to mitigate any risks.
There were enough suitably qualified staff at the service to support people safely. New staff received an induction, which included shadowing more experienced members of staff prior to supporting people with personal care. Staff received observations of their practice and regular supervision. Staff had received training which was appropriate to their role.
The services infection prevention and control policies and procedures were adhered to ensuring both staff and people at the service were protected from cross contamination.
Medicines were managed safely. People received their medicines in accordance with the prescriber’s instructions.
People’s needs were assessed prior to using the service. People felt listened to, respected, and were involved in decisions about their care and support. Care plans outlined individual preferences and wishes and how people wanted to be supported. People and relatives we spoke to felt staff were kind and caring.
The service worked with a wide range of key organisations who were also involved in people’s care.
People, relatives, and staff spoke highly of the registered manager and their dedication to the role.
At the time of the inspection, the location did not care or support anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.
Right Support: Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life.
Right Care: People’s care and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life.
Right Culture: People and those important to them, including social care professionals, were involved in planning their care.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
This service was registered with us on 16 November 2021, and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Recommendations
We have recommended the provider reviews their quality assurance and safeguarding systems and processes.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.