We carried out a review of the data available to us about Age Gracefully Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Age Gracefully Limited, you can give feedback on this service.
Age Gracefully Limited is a domiciliary care agency providing personal care to people living in their own homes. At the time of our inspection there were 26 people using the service.
People's experience of using this service:
¿ People felt safe and the service assessed risks to the health and wellbeing of people who use
the service and staff. Where risks were identified action was taken to reduce the risk where
possible.
¿Recruitment processes were in place to make sure, as far as possible, that people were
protected from staff being employed who were not suitable.
¿Medicines were handled safely by staff who had been assessed as competent to do so.
We gave the provider some guidance about how to improve this in the documentation to ensure this was clear in care plans when this was administered or prompted for people by staff.
¿People received effective care from staff who were well trained and supervised.
¿People felt the service they received helped them to maintain their independence where
possible.
¿People said that staff were caring and respected their privacy and dignity.
¿People received care that was designed to meet their individual needs and preferences.
¿People were supported to have maximum choice and control of their lives and staff supported
them in the least restrictive way possible; the policies and systems in the service supported this
practice.
¿People knew how to complain and knew the process to follow if they had concerns.
¿People's right to confidentiality was protected and their diversity needs were identified and
incorporated into their care plans where applicable.
¿People did not always receive their calls on time, but the provider had put measures in place to make improvements to this. We saw evidence of their call monitoring system and quality monitoring system for this process.
Rating at last inspection:
The service was inspected on 31/01/2018 and was previously rated as Requires Improvement overall.
Why we inspected:
This was a planned comprehensive inspection in line with our inspection programme.
Follow up:
We will continue to monitor all information we receive about this service. This informs our ongoing
assessment of their risk profile and ensures we are able to schedule the next inspection accordingly.
A registered manager was present during the inspection. 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.
At the time of the inspection Age Gracefully Limited supported 51 people who receive some element of support with their personal care. This is the service’s second inspection under its current registration. During our previous inspection on3 November 2015 we rated this service as ‘Good’. However, due to the concerns identified within this report we have changed this rating to ‘Requires Improvement. The rating of ‘Good’ for the question; Is the service Caring?, has remained unchanged.
Staff had not always been recruited safely. Staff had received training in the safeguarding of adults but some staff required training to be updated. Some of the risks to people’s safety had been assessed although some lacked detail and were not always regularly reviewed. People told us they felt safe when staff were in their home, but raised concerns that they were not always informed which staff were coming. People required minimal support from staff with their medicines, however medicine administration records were not always appropriately completed. Some staff had received infection control training and assessments of the environment people lived in where carried out to ensure they were safe. Themes and trends in relation to accidents and incidents were not always reviewed, but investigations about specific incidents were carried out.
People’s physical, mental health and social needs were assessed and support requested from health and social care professionals to aid them in providing care in line with current legislation and best practice guidelines. People were supported by staff who had completed an induction and training programme although some of this training was not up to date. We were told all staff received supervision at least every three months although we were not provided with records to support this. Where people received support from staff with their meals staff his was done so effectively. However the assessment of people’s nutritional needs was not always completed. The registered manager told us they worked with other health and social care agencies to ensure people’s health needs were regularly monitored and transitions to other services were effective. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice, however clearer documentation was required to ensure all decisions made clearly evidenced that they were in each person’s best interest.
People felt staff were caring, treated them with respect and dignity and listened to what they had to say. Staff took the time to talk with people and showed a genuine interest in building positive relationships. Staff were knowledgeable about their needs and people were involved with making decisions about their care. People’s diverse needs were respected. People were encouraged to lead as independent a life as possible. People were provided with information about how they could access independent advocates.
People felt there was a lack of effective communication, primarily with the office based staff. People felt able to contribute to decisions about the individualised care needs. People’s care records were in the process of being transferred to a more detailed format as the current system of care planning was not responsive to people’s needs. People were treated equally, without discrimination. The registered manager had limited knowledge of the Accessible Information Standard, however some efforts had been made to ensure people with communication needs and/or sensory impairment were treated equally. People felt able to make a complaint and were confident it would be dealt with appropriately.
This service is currently suspended with local authority commissioners. This means they cannot currently provide care and support for any new people until they have made sufficient progress with the actions requested by the commissioners. Quality assurance processes were not effective in ensuring the risks to people’s health, safety and welfare were addressed. There was a lack of personal accountability for the performance of office based staff. There was not a strategic approach to ensuring continued learning and development of the service. The registered manager had the best interests of people at heart but currently did not have the processes and systems in place to address the declining standard of service people received. People completed a questionnaire about the quality of the service provided and their concerns have been recorded within this report.
We identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we have told the provider to take at the back of this report.
This inspection took place on 3 November 2015. Age Gracefully Limited is a domiciliary care service which provides personal care and support to people in their own home in Nottingham.
There is a registered manager and she was available during the inspection. A registered manager is a person who has registered with the Care Quality Commission 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.
Staff knew how to keep people safe and understood their responsibilities to protect people from the risk of abuse. Risks to people’s health and safety were managed and plans were in place to enable staff to support people safely. There were sufficient numbers of staff to meet people’s care needs and staff were recruited safely. People received the level of support they required to safely manage their medicines.
Staff received appropriate induction, training, supervision and appraisal. .People’s rights were protected under the Mental Capacity Act 2005. People received the assistance they required to have enough to eat and drink. External professionals were involved in people’s care as appropriate.
Positive and caring relationships had been developed between staff and people who used the service. People were involved in the planning and reviewing of their care and making decisions about what care they wanted. People were treated with dignity and respect by staff who understood the importance of this.
People received the care they needed and staff were aware of the different support each person needed. Care records provided sufficient information for staff to provide personalised care. People felt able to make a complaint and knew how to do so.
People and their relatives were involved in the development of the service. Staff told us they would be confident raising any concerns with the management and that the registered manager would take action. There were systems in place to monitor and improve the quality of the service provided.