Background to this inspection
Updated
6 December 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 team consisted of 1 inspector 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
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 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 12 October 2023 and ended on 23 October 2023. We visited the location’s office on 12 October 2023 and 18 October 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection and we sought feedback from the local authority. We used this information to plan our inspection. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection
We spoke with 10 people who used the service and 9 relatives about their experience of the care provided. We spoke with 10 members of staff including the registered manager, care and compliance managers, senior carers and care staff. We also spoke to 3 health professionals who have contact with the service.
We reviewed a range of records. This included 7 people’s care records, 3 staff files in relation to recruitment and a variety of records relating to the management of the service.
Updated
6 December 2023
About the service
Annies Homecare Services is a domiciliary care agency providing personal care to people living in their own houses and flats. At the time of the inspection 59 people were 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 the 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.
The provider had failed to make all of the required improvements since the last inspection. The provider did not have robust oversight of the quality and safety of the care people received. Risks to people’s safety were not assessed or managed appropriately. People did not always receive personalised care which reflected their individual needs and preferences. People’s care plan and risk assessment documentation was poorly completed and people’s end of life care needs and wishes had not always been considered.
The provider did not have effective processes in place to analyse and learn from complaints, accidents, and incidents in order to drive improvement. The provider had not always submitted appropriate notifications to CQC in line with their regulatory responsibilities. Employment checks were completed for all new staff; however, documentation was not always checked robustly to ensure all details were recorded.
Staff told us they did not always feel supported or listened to and we received mixed feedback about how well the provider communicated and the effectiveness of the leadership. Staff did not always feel there was an open and positive culture in the service.
The provider had made improvements to their monitoring of people’s care visits. People and relatives told us there were now enough staff available to provide support. People had not experienced missed calls, although punctuality remained an issue. The provider had implemented a new system to monitor the administration of people’s medicines. We found people’s medicines were now managed safely.
The provider worked in partnership with other health professionals in order to support people’s needs. People were not always supported to have maximum choice and control of their lives; however, staff did support them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People and relatives told us they were able to give feedback and felt comfortable discussing any concerns with the management team.
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 (published 11 November 2022).
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 the provider remained in breach of regulations.
Why we inspected
When we last inspected Annies Homecare Services on 12 October 2022, breaches of legal requirements were found. This inspection was undertaken to check whether they were now meeting the legal requirements. The inspection was also prompted in part by concerns received about the management of safeguarding concerns and oversight at the service. A decision was made for us to inspect and examine those risks.
We undertook a focused inspection to review the key questions of safe, responsive and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Annies Homecare Services on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to safe care and treatment and governance at this inspection.
Please see the action we have told the provider to take at the end of this report. 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.
Follow up
We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.