Archived: ACASA

Updated 27 April 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 16, 18 and 19 February 2016 and was announced. The provider was given 48 hours’ notice of the inspection to ensure that the people we needed to speak with were available. The inspection team consisted of one inspector.

Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information included in the PIR along with information we held about the service, for example, statutory notifications. A notification is information about important events which the provider is required to tell us about by law. We also reviewed the provider’s website.

During the inspection we spoke with the registered manager and the provider’s nominated individual, who has overall responsibility for supervising the management of the service. We also spoke with the team manager, the manager of the React reablement service, the human resources manager and administrator, the quality and compliance manager, a care coordinator, a field care supervisor and 16 staff.

We visited nine people in their homes. We spoke with people and their relatives about their care and looked at their care records. We observed some aspects of care, such as staff preparing people’s meals and supporting them to move.

We spoke with a further 10 people on the telephone to find out about their experience of the quality of care provided by the service. Following the home visits we spoke with three health and social care professionals.

We reviewed 19 people’s support plans, including daily records and medicines administration records (MARs). We looked at ten staff recruitment files, and reviewed the provider’s computer training records. We reviewed the provider’s policies, procedures and records relating to the management of the service. We considered how comments from people, staff and others, as well as quality assurance audits, were used to drive improvements in the service.

This was the first inspection of the service since it was registered on 30 July 2014.

Updated 27 April 2016

The announced inspection took place on 16, 18 and 19 February 2016. ACASA (Alexander’s Care and Support Agency) provides a domiciliary care service to enable people living in the Basingstoke and the surrounding area to maintain their independence at home. At the time of our inspection there were 146 people using the service, who had a range of health care needs. Some people were being supported to live with dementia, whilst others were supported with specific health conditions including epilepsy, diabetes, sensory impairments and mental health diagnoses. The agency also provided a reablement service called React, in partnership with Hampshire County Council. This service provided an intensive period of support for people in their own homes to re-learn skills and build the confidence they need to reach their maximum level of independence. At the time of the inspection the provider deployed 56 staff to care for people and meet their individual needs.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager also had responsibility for two other services within the care group. Therefore, the provider had appointed a local team manager who had responsibility for running the service on a day to day basis. A manager had also been appointed to supervise the delivery of the React service.

People were supported by staff they could trust, who made them feel safe. Relatives had no concerns for the safety of their loved one and told us they experienced good continuity and consistency of care from conscientious, dedicated staff.

Staff had received safeguarding training and knew how to recognise and report potential signs of abuse. Records showed safeguarding incidents had been reported, recorded and investigated in accordance with the provider’s safeguarding policies and local authority guidance. People were kept safe as staff understood their role in relation to safeguarding procedures. The registered manager and team manager ensured staff safety at work by effectively implementing the provider’s lone worker policy.

The registered manager ensured people were protected people from harm by identifying risks associated with their care and managing these effectively. Designated staff completed needs and risk assessments, which promoted people’s independence, while keeping them safe. Risk assessments gave staff clear guidance to follow in order to provide the required support to keep people safe. We observed staff support people safely in accordance with their risk assessments and support plans.

The registered manager completed a weekly staffing analysis to ensure there were sufficient suitably qualified staff available to keep people safe and meet their needs. Rosters demonstrated that the required number of staff to meet people’s needs was always provided, which we observed in practice. The provider had a stringent annual leave policy, which ensured there were sufficient staff to cover popular public holidays. Office staff had all completed the provider’s required training which provided resilience to cover any unforeseen staff absence.

Recruitment files showed that a thorough system was in place for pre-employment checks and the required records were available to confirm these had taken place. The provider had obtained proof of candidates’ satisfactory conduct in previous health and social care employment. People were safe as the provider had assessed the suitability of staff to provide care to people in their own home.

Staff told us they felt confident managing medicines and that their training had prepared them to do this. People received their medicines safely, administered by staff who had completed safe management of medicines training and had their competency assessed by the registered manager. People told us that staff supported them where necessary with their medicines, in accordance with their care plan.

Staff were enabled to meet people’s needs with an effective programme of induction, supervision and appraisal. Required staff training was up to date and refreshed regularly to ensure staff retained and updated the skills and knowledge required to support people effectively.

People were supported to make their own decisions and choices. People’s human rights were protected by staff who demonstrated clear understanding of guidance and legislation relating to consent and mental capacity.

People’s specific dietary requirements, preferences and any food allergies were detailed within their support plans. Staff had completed training in relation to food hygiene and safety and knew people’s food and drink preferences. We observed people supported appropriately to ensure they received sufficient to eat and drink.

Staff recognised changes in people’s needs in a timely way and sought advice from relevant health professionals, which we observed being implemented effectively in practice. The service worked in partnership with a range of health care professionals to ensure people’s health care needs were met.

People told us staff were kind and compassionate and treated them with respect. Staff had invested time to build positive relationships with people who enjoyed their company. During home visits we observed relationships between people and care staff, which were warm and caring. Conversations flowed naturally between people and staff about topics of general interest and other subjects, which demonstrated that staff knew people well and took a keen interest in their lives and wellbeing.

People were actively involved in making their decisions and planning their own care and support. People told us they were able to make choices about their day to day lives and care staff respected those choices.

People were involved in developing their care and support plans, which were personalised and detailed daily routines specific to each person. The management team were committed to ensuring people were involved as much as they were able to be in the planning of their own care.

People’s needs were assessed and regularly reviewed to ensure their care and support was responsive to any identified changes. Records accurately reflected people’s wishes and were up to date. Staff were provided with necessary information and guidance to meet people’s needs. People’s and staff records were stored securely, protecting their confidential information from unauthorised access.

The service was well led. Senior staff provided clear and direct leadership and effectively operated systems to assure the quality of the service and to drive improvements. Feedback from people, their relatives, and staff was sought to identify changes required to improve the quality of care people experienced. The provider’s audits were used to review changes implemented, and ensure all required actions had been taken.