Background to this inspection
Updated
19 July 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 inspection took place on 5 July 2018 and was unannounced. We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.
Inspection site visit activity started on 5 July 2018 and ended on 9 July 2018. We visited the office on 5 July 2018 to meet the provider and registered manager; and to review care records, policies and procedures. We made telephone calls to people and relatives on 6 July 2018 and spoke with care staff employed by the service on 9 July 2018.
The inspection was carried out by one adult social care inspector and one Expert by Experience. Experts by experience are people who have personal experience of using or caring for someone who uses this type of care service. Their involvement was phoning people using the service and their relatives to ask them their views of the service.
Before the inspection, we checked for any notifications made to us by the provider and the information we held on our database about the service and provider. Statutory notifications are pieces of information about important events which took place at the service, such as safeguarding incidents, which the provider is required to send to us by law.
During the inspection, we spoke with three people using the service, four relatives, two care staff, an independent consultant, the registered manager and the provider.
We reviewed the care records for five people receiving a service to see if they were up-to-date and reflective of the care which people received. We also looked at personnel records for five members of staff, including details of their recruitment, training and supervision. We reviewed further records relating to the management of the service, including complaint and safeguarding records, to see how the service was run.
Updated
19 July 2018
This inspection took place on 5 July 2018 and was announced. We gave the provider 48 hours' notice of this inspection to ensure that the registered manager would be available to support us with this process.
This inspection was the first inspection of the service since it was registered with the Care Quality Commission (CQC) on 6 July 2017.
Angelic Care is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults some of who are living with dementia. At the time of the inspection there were 10 people using the service.
Not everyone using Angelic Care receives 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.
There was a registered manager in post at the time of 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.
People and their relatives told us that they felt safe and well supported by the care staff of Angelic Care. Care staff knew of the different types of abuse and were able to tell us of the steps they would take to report abuse and to keep people safe and free from harm.
Risk assessments in place identified people’s health and care associated risks and gave clear guidance to care staff on how to reduce or mitigate the risk in order to keep people safe. However, the provider needs to ensure that people’s individualised risks are identified and assessed so that care staff have clear guidance to follow so that people are not placed at risk of harm.
Care plans detailed people’s personal information with details of the support that they required. These were reviewed annually or sooner where identified needs had changed. However, care plans were not always person centred and did not always detail people’s likes, dislikes and preferences to how they wished to receive their care. The provider addressed this immediately and following the inspection sent us updated care plans which reflected people’s wishes.
The service currently did not provide people with medicine support. However, the provider had the appropriate policies and procedures in place to ensure medicines were administered to people safely and as prescribed if they needed to in the future.
The service followed robust procedures when recruiting care staff so that only those care staff assessed as suitable to work with vulnerable adults were employed.
The service ensured that all accidents and incidents were reported and recorded with details of the incident and the actions taken as a result in order for the service to learn and improve.
Care staff received a comprehensive induction, training and support to carry out their role effectively. This included regular supervision and monitoring checks. Care staff were yet to receive an annual appraisal as none of them had fully completed a year of employment.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. Care staff demonstrated the ways in which they obtained consent from people. They understood the need to respect a person's choice and decisions.
People knew the registered manager and the care staff that supported them. People and relatives told us that they had developed caring and meaningful relationships with their regular allocated care staff based on mutual respect.
People were encouraged and supported to maintain their independence where possible.
People were supported to maintain good health and had access to a variety of healthcare services where required.
Peoples were supported with their nutrition and hydration needs where this was an assessed need.
People and relatives felt confident and able to raise any concerns or complaints about the care and support that their relative received directly with the registered manager. People and relatives also confirmed that any concerns or complaints they raised would be appropriately addressed.
The service regularly requested feedback from people who used the service through monitoring visits and satisfaction checks. The provider was yet to implement annual satisfaction surveys for relatives to complete.
The provider held regular staff meetings which enabled effective communication exchange and encouraged staff to discuss issues and areas for improvement.
The provider had a number of processes and systems in place to monitor the overall quality of care being delivered. The provider agreed to ensure that these are completed robustly to ensure that all issues and concerns are identified and addressed to support continuous improvement and learning.