Amber Valley Total Care

Updated 21 March 2024

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 Health and Social Care Act 2008.

Inspection team

This inspection was carried out by 2 inspectors and an Expert 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.

Service and service type

Amber Valley Total Care 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

This inspection was announced.

We gave the service 24 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 21 November 2023 and ended on 24 November 2023. We visited the location’s office on 21 November 2023.

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 sought feedback from professionals who work with the service. We used all this information to plan our inspection.

Updated 21 March 2024

About the service

Amber Valley Total Care is a domiciliary care agency providing personal care to people in their own homes. The service supports younger and older people, including people with dementia. At the time of our inspection there were 52 people using the service.

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

The governance of the service was not effective because systems were not in place to identify areas where improvements were needed. Audits were not always effective in identifying where actions needed to be taken. The provider was not sure about what incidents and events they were legally required to report to CQC in line with their regulatory requirements.

The culture of the service was not inclusive and empowering for all staff. Some staff felt unable to raise concerns due to the structure and dynamics in the management team.

Risks to people were not always assessed and plans to mitigate risk and guide staff on how to support people in relation to specific risks were not always in place.

Staff were not recruited safely; pre-employment checks were not completed thoroughly.

People were not always supported safely with their medicines because the recording of medicines were not in line with best practice guidance.

We could not be assured that people were supported to have maximum choice and control of their lives or that staff supported them in the least restrictive way possible and in their best interests; because the policies and systems were not in place to support this practise.

People felt they were safely supported by the care staff. The care staff had good awareness of abuse and neglect and knew how to report any safeguarding concerns. However, people were at increased risk of harm because staff were not safely recruited, risks were not adequately assessed, care plans were not always comprehensive and there were shortfalls in communication between the staff and management.

Care staff received appropriate training and were confident in supporting people with their care. They attended to people's needs in a timely manner and had enough time allocated to spend with people, and knew their needs well. People told us staff were caring and reliable.

People had the opportunity to provide feedback on the service. There was a complaints policy in place and formal complaints were investigated.

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

The last rating for this service was inadequate (published 1 April 2023) and there were breaches of regulations. At this inspection we found the provider remained in breach of regulations.

Why we inspected

We carried out an announced comprehensive inspection of this service on 26 January 2023. Breaches of legal requirements were found. The provider was issued Warning Notices requesting to improve safety of care and treatment, recruitment processes and governance of the service.

We undertook this focused inspection to check they now met legal requirements. We planned to inspect the key questions of Safe and Well led, however we found there was a concern with people’s mental capacity assessments, so we widened the scope of the inspection to also include the key questions of Effective.

This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led.

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 remained inadequate. 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 Amber Valley Total Care on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment, recruitment and governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this time frame and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures