Andersen Care Agency

Updated 13 February 2024

The inspection

We carried out this performance review and assessment under Section 46 of the Health and Social Care Act 2008 (the Act). We checked whether the provider was meeting the legal requirements of the regulations associated with the Act and looked at the quality of the service to provide a rating.

Unlike our standard approach to assessing performance, we did not physically visit the office of the location. This is a new approach we have introduced to reviewing and assessing performance of some care at home providers. Instead of visiting the office location we use technology such as electronic file sharing, video and phone calls to engage with people using the service and staff.

Inspection team

The inspection was completed by 1 inspector and 1 Experts 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. A Pharmacy inspector also supported this inspection.

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 24 hours’ notice of the inspection to enable the registered manager to arrange for us to speak with people, staff, and arrange for documents to be sent to us. The inspection activity started on 29 November 2023 and ended on 4 January 2024.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We spoke with the quality assurance lead for the local authority to gain their views and the outcomes of their assessments of the service.

During the inspection

This inspection was carried out without a visit to the location’s office. We used technology such as video calls to speak with the registered manager, we telephoned people, their relatives and staff. We were sent people’s care records electronically in a secure way. We spoke with 2 people over the phone, we contacted more but they did not want to speak with us. We spoke with 9 people’s relatives and 4 members of staff. We reviewed 3 people’s risk assessments, care plans, reviews in full. Staff recruitment checks were completed for 2 members of staff. Staff rotas and spot checks, emergency plans, and quality monitoring audits were also reviewed.

Updated 13 February 2024

About the service

Andersen Care Agency is a domiciliary care service providing personal care in people’s own homes. At the time of our inspection there were 17 people using the service. The service was supporting older people and adults with physical disabilities.

People’s experience of using this service and what we found

We found there were shortfalls with how risks which some people faced were assessed, managed and planned for. Certain high risks were not identified and fully explored. Staff did not have robust care plans to guide their practice and promote people’s safety. The provider did not effectively assess this aspect of the service they provided. Improvements were required with how they assessed and managed high risks.

The providers audits did not identify the issues we found in relation to the planning and management of people’s medicines, how incidents were responded to, and how staff and managers evidenced the quality checks they completed. Improvements were needed in how the provider assessed these aspects of their service.

The registered manager was open to all of this feedback and told us they would make these improvements.

Despite these findings, we found there was a positive culture at the service and people received a person-centred care experience. People’s relatives said their relatives were safe and well cared for. One person’s relative said “She [relative] is quite happy, their regular carer makes her laugh.” Another person’s relative said, “[Name of relative] is 100 per cent safe and happy. Their main carer is fantastic, [name of carer] is brilliant.”

People received care visits at times they were happy with and saw a regular group of care staff. New staff were introduced to them and spent time getting to know them with a more experienced member of staff before they visited alone.

Relatives reported how respectful, polite, and caring staff were to their loved ones. One person’s relative said, “They [care staff] are chatty and kind, [name of carer] dances with him, [name of another carer] shares the football news.”

Staff told us they spent time with people and were not under pressure to rush about to the next care visit. If they needed to stay longer, they did and reported this to the office. The managers celebrated people’s birthdays with a cake, card, and a visit from them and the person's main carer.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

At the time of the inspection, Andersen Care Agency did not support anyone with a learning disability or an autistic person. We assessed the care provision under Right Support, Right Care, Right Culture, as the service is registered as a specialist service for this population group. The registered manager had arranged training for themselves to assist them to make plans to fulfil ‘Right Support, Right Care, Right Culture’ if they supported anyone with a learning disability or autism in the future.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published on 24 November 2017).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding which had not been inspected for some time.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Andersen Care Agency on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified 2 breaches in relation to how the provider assessed the quality of the service, with risk management, medicines support.

Please see the action we have told the provider to take at the end of this report.

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.