Archived: Augusta Care Limited

Updated 6 October 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.

We undertook an announced inspection of Augusta Care Limited on 14 September 2016. We gave the service 48 hours’ notice because we needed to be sure that the registered manager and staff would be available. The inspection was completed by one inspector.

We looked at information that we held about the service including information received and notifications. Notifications are information on important events that happen in the service that the provider is required to notify us about by law.

During the inspection we visited the service’s office and three of the homes where people lived. We spoke with five people who used the service. We also observed how the staff interacted with people who had limited or no communication skills. This was to help us understand the experience of people who could not talk with us.

We spoke with the registered manager, the team manager, and two care workers. We requested feedback about the quality of the service provided from a representative of the Cambridgeshire and Peterborough Clinical Commissioning Group; Healthwatch Cambridgeshire; and the contracts monitoring teams from Cambridgeshire and Peterborough. We received feedback about the service provided from a representative of the Norfolk Council quality team.

We looked at four people’s care records, two staff recruitment files and the systems for monitoring staff training and development. We looked at other documentation such as quality monitoring, minutes of meetings and medicine administration records.

Updated 6 October 2016

Augusta Care Limited based in Wisbech is a domiciliary care service registered to provide personal care to people in their own homes. People receiving care have a range of needs which includes learning disabilities. There were 13 younger adults being supported with the regulated activity of personal care at the time of our inspection.

This comprehensive inspection took place on 14 September 2016 and was announced. This was the first inspection of this service since it was registered with the Care Quality Commission on 12 January 2016.

There was a registered manager in place during this 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.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and report on what we find. The registered manager had an understanding that people, who were being supported by the service and who lacked the mental capacity to make day-to-day decisions, should have an application to the Court of Protection made on their behalf. Staff were able to demonstrate a basic understanding of the MCA. Any decisions made on people's behalf by staff would be in their best interest and as least restrictive as possible.

People had care records in place which included information on how they wished to be supported to maintain their independence. However, people’s personal development goals were not always listed as guidance for staff. Care records documented people’s care and support requirements and any assessed risks.

People were assisted where required, to contact and access a range of external healthcare professionals. People were supported by staff where appropriate to prepare and help cook their own meals and make their own drinks.

People had their choices about how they would like to be supported respected by staff. People were assisted by staff in a caring manner. Staff promoted people’s privacy and dignity.

Plans were in place to minimise people’s identified risks and to prompt staff on how to assist them safely. These records and reviews of these records, documented that people and/or their appropriate relatives had been involved in and agreed their plan of care. However, some monitoring charts such as food and fluid intake risk assessments were not a detailed enough record for people deemed to be at risk. This meant that there was an increased risk that records could not detail whether a person at risk had drunk sufficient amounts of drink to prevent them becoming dehydrated or eaten sufficient amounts of food.

People were supported to maintain their links with the local community and promote their independence. People were helped to take part in recreational and work related activities.

Arrangements were in place to ensure that people’s medicines were administered safely. Records regarding the administration of people’s prescribed medicines were kept. People’s care and support plans and risk assessments did not detail who was responsible for the ordering, collection and disposal of people’s medicines. How people should store their medication safely had not been risk assessed. Risk assessments on whether this storage method was safe, would demonstrate whether there was a potential risk to people and/or the other people who shared their home.

There was a sufficient number of staff to provide people with safe support and care, agency staff were used to cover any shortfalls. Staff were trained to provide care and support which met people’s individual needs. The standard of staff members’ work performance was reviewed during supervisions and direct observations. This was to make sure that staff were competent and confident to provide the agreed care and support.

Staff understood their responsibility to report any suspicions of harm or poor care practice. There were pre-employment essential checks in place to ensure that all new staff were deemed safe and suitable to work with the people they supported.

There was a procedure in place to listen to people’s complaints. The registered manager sought feedback about the quality of the service provided from people who used the service. Staff meetings took place and staff were encouraged to raise any suggestions or concerns that they may have had.

Quality monitoring processes to identify areas of improvement required within the service were in place. Improvements identified as required were either completed or were on-going.