Able Trust Care is a domiciliary care agency which provides care and treatment to people living in their own home. At the time of this inspection the agency was providing care for 14 people.There was a registered manager in post who was also the provider. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. The registered manager was present during our inspection.
At our last inspection in September 2015 we found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to staffing, recruitment, medicines records, respect and dignity and good governance. We asked the provider to submit an action plan to tell us how they planned to meet the Regulations. We carried out this inspection to see if the provider had taken action in line with their action plan.
The provider did not follow good recruitment processes. We found some application forms for new staff had not been completed fully. This meant the provider could not satisfy themselves that the staff they employed were suitable to work at the agency.
The registered manager did not ensure staff followed safe medicines management procedures and robust audits of medicines records had not been carried out by the registered manager. Where there had been a medicines incident the registered manager had failed to follow the requirements of their registration by notifying CQC.
Actions as stated by the registered provider in their action plan had not been completed in the timescale we were told they should be. We found continued breaches of Regulation from our last inspection.
Risks to people had not always been identified or recorded in a way that staff would know what action to take to avoid harm for people. Should people need to get hold of someone outside of office hours, they had been provided with an out of hours contact number. This could be used by both people and staff.
Care records for people were not always up to date and some information was missing. However, staff we spoke with said they knew people and found the information they had been provided with was sufficient to enable them to give the care people required.
Although the registered manager had commenced quality assurance audits since our last inspection, she had not always identified shortfalls in records. Other quality assurance processes had been introduced to obtain feedback from people as to the care that was provided to them. Staff had the opportunity to attend staff meetings to discuss all aspects of the agency.
Improvements had been made in relation to staff deployment which meant most of time staff arrived when people expected them, although we did receive mixed responses from people in relation to this. Staff were allocated travelling time between people which had not been evident at our last inspection and staff were provided with a written rota to show them where they needed to be each day.
People and relatives told us that staff were kind and caring and they were very pleased with the care the agency provided to them. However, we received some feedback which was not so positive. People had signed to show they consented to the care and treatment being provided to them.
Staff were aware of their responsibilities in relation to safeguarding people from abuse and knew how to report any concerns they may have. Staff demonstrated to us how they would support someone to make a complaint. However, people told us they were not always satisfied at the way their complaints were responded to.
Training and supervisions had been completed by the registered manager, however this was not always consistent. Staff told us however that training was good and that they felt supported by the registered manager.
People were supported to eat and drink sufficient amounts and staff always ensured food or drink they provided to people were left within their reach. If people required it, staff would arrange for a GP to call.
During the inspection we found continued breaches of three of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 as well as one new breach relating to the Registrations Regulations. We also made some recommendations to the provider. You can see what action we told the provider to take at the back of the full version of the report.