AVH Care

Updated 31 July 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was completed by one inspector

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. They currently provide care and support for three people.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection. Inspection activity started on 1 July and ended on 5 July 2019. We visited the office location on 1 July 2019.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We reviewed all the information we had received from the service, including their action plan. We sought advice and feedback from the commissioning teams and their quality assurance team who had been working with this service.

During the inspection

We looked at three care plans and associated risk assessments during the office visit. We also reviewed training files and quality audits in respect of medicine records and care plan documentation.

We spoke with two relatives of people who received care and received an email from a third. We spoke with the registered manager and nominated individual as well as two care workers. We were unable to speak with people using the servcie due to their complex needs.

After the inspection

We continued to review care plan documentation and risk assessments. We sought further feedback from the local authority quality assurance team and commissioning team.

Updated 31 July 2019

About the service

AVH Care is a domiciliary care agency which provides personal care in people’s own homes. It currently provides care and support for three people.

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

People and their relatives expressed a high level of satisfaction for the care and support delivered by this service. Comments included “They are all very compassionate and come when they say they will. They are excellent.”

There was a small staff team of four, which included the registered manager and provider of the agency being involved in the delivery of each care package. This meant care was consistent and staff knew people and their needs very well.

There had been improvements to the care plans and risk assessments which allowed staff to deliver safe and consistent care to people. Plans were much more person centred and included health conditions and what staff should do to best support people.

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. Where people were taking risks because they wished to remain in their own home, the service had considered how best to reduce such risks. This had been done in conjunction with the advice of other healthcare professionals.

Since the last inspection, some key staff training had taken place, but this was still work in progress. This was because they were a very small staff team so finding the right times for training sometimes proved difficult.

The registered manager had worked hard to ensure quality audits were being used meaningfully to help drive up improvement. For example, in medicines management. However, it was too soon to judge whether this was fully embedded and could be sustained. The provider had deliberately chosen to restrict the service to support only three people. These people had been having a service for some time, so their needs were well known. We were unable to judge how robust systems and improvements will be sustained once the service grows and takes on more people.

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

Rating at last inspection and update.

At the last inspection this service was rated requires improvement (Published 14 May 2019) We found breaches in regulation 12 – safe care and treatment and 17- good governance. We issued warning notices in respect of these breaches. We also issued requirement notices in respect of Regulation 18 Registration Regulations 2009 Notifications of other incidents and Regulation 18 HSCA RA Regulations 2014 Staffing. The provider had sent us an action plan after the last inspection to show what they would do and by when to improve.

At this inspection enough improvement had been made to show the warning notices and requirements had been met. Improvements had been made in respect of staff training but it was too early to see if this new approach could be sustained.

Why we inspected

This inspection was a planned focused inspection to review whether the warning notices in relation to safe care and treatment and good governance, had been met. We checked to see if they had followed their action plan and met legal requirements.

This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led which contain those requirements.

We reviewed the information we held about the service. No areas of concern were identified in the other Key Questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those Key Questions were used in calculating the overall rating at this inspection.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.