Apex Prime Care - Hastings

Updated 1 November 2018

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.

This comprehensive inspection took place between 11 and 25 September 2018. It involved visits to the agency’s office, visits to people in their own homes, telephone interviews with people and/or their relatives and conversations with staff. The service was given a couple of hours’ notice of the inspection because it provides a domiciliary care service and we needed to ensure staff were available in the office to be able to conduct the inspection. The inspection was undertaken by an inspector 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.

Before our inspection we reviewed the information we held about the agency, including the previous inspection report. This enabled us to ensure we were addressing any potential areas of concern. The provider had sent us an information return (PIR) in which they outlined how they ensured they were meeting people's needs and their plans for the next 12 months. As part of the inspection, we reviewed the PIR. We also reviewed other information about the service, including safeguarding alerts which had been made and notifications which had been submitted. A notification is information about important events which the provider is required to tell us about by law. We also contacted the local authority before and after the inspection, to receive their comments.

We met with five people who received a service in their own homes. We received comments on the telephone from five people, five people’s relatives and one professional. We spoke with nine staff, all four of the office staff and the registered manager. We reviewed eight people’s records, including the five people we met with.

During the inspection we reviewed other records. These included six staff recruitment records, training and supervision records, medicines records, the rota of visits to people, risk assessments, quality audits and policies and procedures.

Updated 1 November 2018

This inspection took place between 11 and 25 September 2018. The inspection involved visits to the agency's office, to people’s own homes, conversations with people, their relatives, staff and professionals. The agency provided approximately 90 people with a domiciliary service. Not everyone using the agency received a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The agency provided support to people in the age range of 22 to 94 years. Some people were older people, some lived with long-term medical conditions, some lived with substance abuse needs, some with a learning disability or mental health needs. People received a range of different support, according to their individual needs. Some people received occasional visits, for example weekly support to enable them to have a bath. Other people needed more frequent visits, including visits several times a day to support them. This could include two care workers and the use of equipment to support their mobility. Some people needed support with medicines and meal preparation. Services were provided to people who lived in Hastings and surrounding areas.

The service had a registered manager in post. 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 provider for the agency is Apex Primecare Limited, a national provider of care.

This was the agency’s first inspection as Apex Primecare Limited. The agency itself had been providing a service to people for a period of time under a different provider. Many of the people and staff had continued with the agency when it started to be provided by Apex Primecare Limited.

Improvements were needed in record keeping. This was because although staff acted to reduce people’s risk and meet their needs, some matters were not documented, to ensure all staff could be made aware of them. The area manager did not provide the registered manager with a copy of monitoring reports and own reviews of the quality of care provided by the agency.

Where people had risks, care workers took action to ensure people’s risk was reduced. Where staff or the agency’s managers identified issues relating to people’s safety, they took appropriate action, including contacting relevant external professionals. There were safe systems to reduce people’s risk of infection.

Enough staff were employed to provide people with a responsive, flexible service. The agency had effective systems for the recruitment of staff, which ensured that people were supported by staff who had been assessed as safe to work with people in their own homes.

Staff and managers were aware of how to ensure people were safeguarded and worked within the local authority’s safeguarding procedures. Care workers were confident if they reported issues, including out of office hours, that appropriate action would be taken to safeguard people.

The provider had ensured that people’s consent to care was sought in line with the principles of the Mental Capacity Act (MCA) 2005. All of the staff had a clear understanding of their responsibilities under the MCA. They followed them in practice when they were with people.

Staff received training to ensure they remained up to date with best practice. People told us they felt staff were trained in their roles. This was confirmed by staff, who commented favourably on the training and supervision they were given. This was also shown by the agency’s records.

People who needed assistance with their meals and drinks received the support they needed, in the way they wanted.

The agency worked with other professionals to ensure people were supported in the way they needed. Staff told us about their close working relationships with external professionals. This was supported by people’s records.

People's independence, dignity and privacy was respected. People commented on the kindness and support they received from care workers. They also told us that care workers supported their independence and treated them as individuals. We saw care workers were very polite to people, showing empathy when supporting them.

People received a responsive service. People commented on the good continuity of care they received from the same group of care workers. This was confirmed by staff and the agency’s records. People were involved in drawing up their own care plans so care workers knew how to meet their individual needs. Care workers followed people’s care plans when they gave them care.

Any complaints and concerns were handled appropriately and people were confident the provider would take action if they raised issues. This was supported by the agency’s records.

The agency’s own auditing systems identified areas for improvement and that action was taken when needed. Recent actions had included a review of time given to care workers doe journeys between visits and developments in record-keeping in relation to certain aspects of medicines.

Both people and staff told us the agency’s management systems were person-centred. Staff said they felt consulted by the management, this included the regular staff meetings. The registered manager was open to different ideas and keen to foster developments in service provision.