About the service Abel Care Ltd is a domiciliary care agency that provides personal care to people living in their own homes,
including older adults and younger disabled adults. 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. At the time of our inspection the service was supporting 25 people.
People’s experience of using this service and what we found
We found that risks to individuals were not always assessed and the service was not analysing accidents and incidents to ensure lessons were learnt. The timeliness of visits was not always reflective of people's preferences.
Systems had been established to safeguard people from the risk of abuse. Medicines were being managed in a safe manner. People were protected from the risk of infection. There were enough staff working at the service and pre-employment checks were carried out on prospective staff.
People were not supported to have maximum choice and control of their lives and staff did not 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. Staff were not always provided with ongoing supervisions and an appraisal. We recommended that the service review the support provided to staff to enable them to provide effective care and support to people.
Assessments were undertaken to determine people’s needs before they moved into the service. Staff received training to support them in their roles. People’s nutritional needs were met, and they told us they enjoyed the food. People were supported to access relevant healthcare professionals.
People told us they were treated in a caring manner by staff. Staff understood how to support people in a way that respected their dignity, privacy and independence. People were consulted about the care they received.
The service did not provide information in an accessible format to ensure people knew about the care they were receiving. People were not involved in the creating of or reviewing of their care plans. We recommended that the service ensure people were consulted about their care plans and deliverance of their care package.
People told us they received personalised care and support. Systems had been set up for dealing with complaints and people and their relatives told us they knew how to make a complaint. Staff were trained in end of life care and knew how to provide appropriate support.
We found there were shortfalls in the governance systems that failed to identify the concerns we found during our inspection.
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 good (published 22 December 2016). The service is now rated requires improvement.
Why we inspected
This was a planned inspection based on the previous rating.
We have found evidence that the provider needs to make improvements. Please see the full report.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement
We have identified breaches in relation to safe care and treatment, the need for consent, person centred care and good governance.
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.