Angila Care Ltd

Angila Care Ltd is a domiciliary care service providing support and personal care to people living in their own homes. At the time of our inspection the service was supporting 12 people.

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

Audits were completed to assess, monitor, and improve the quality of the service but we found not all areas were monitored robustly. Recruitment was not managed safely. Whilst some systems had improved, we found continued shortfalls. The registered manager responded promptly to the shortfalls we found and we were assured effective action had been taken to protect people from the risk of harm.

Care records were clear and well maintained. The provider had made improvements to how they assessed and managed the risks people were exposed to. Staff knew people well and supported them based on their needs, choices, and preferences.

Systems were in place to effectively reduce the risk of infection. Medicines were managed safely. People and relatives spoke positively about the service and said call times were consistent. They said staff were kind and caring and they felt safe. They gave examples of staff going above and beyond. One person said, “All the carers even the newer ones will go the extra mile.”

The provider had made improvements to how the service was managed. They worked closely with people, relatives, staff and other stakeholders. They spoke passionately about plans to further improve the service .

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 2 November 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

This service has been in Special Measures since 29 November 2022. During this inspection the provider demonstrated improvements have been made, however further work was required to continue to develop the service and maintain people's safety. The service is no longer in 'Special Measures'.

Why we inspected

We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers the findings in relation to the Key Questions Safe and Well-led which contain those requirements. We have found evidence the provider needs to make improvements. Please see the Safe and Well-led sections of this full report.

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 inadequate 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 Angila Care Ltd on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe recruitment and good governance.

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.

Angila Care Ltd is a domiciliary care agency providing personal care to people in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of our inspection there were 31 people receiving personal care.

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

People were not always safe. People were at risk of harm as the provider had not identified, assessed or mitigated risks. Accidents and incidents were not recorded. Safeguarding incidents were not always identified and acted upon appropriately. Medicines were not managed safely.

Recruitment processes were not robust in checking people were safe and suitable to work in the service. People’s care needs were not always met as staff were not deployed effectively. People and their relatives told us care calls were often late and staff did not stay the full duration of the call. This was confirmed in care records we reviewed.

Care records were not accurate, did not reflect people’s needs and were not clear about the care to be provided on each call. Complaints and concerns were not recorded.

There was a lack of effective leadership and an ineffective governance structure which meant the service was not appropriately monitored at manager or provider level.

People and their relatives said the staff were lovely, friendly and polite. Staff said they enjoyed their jobs and felt supported by the office staff.

The nominated individual told us action would be taken to address the concerns we identified at this inspection.

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 requires improvement (published 22 August 2019) and there were breaches of regulation. The provider did not complete an action plan after the last inspection to show what they would do and by when to improve.

Why we inspected

We carried out an announced comprehensive inspection of this service on 29 May and 11 July 2019. Breaches of legal requirements were found. We undertook this focused inspection to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

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 requires improvement to 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 Angila Care Ltd on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

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

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

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service is therefore 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 timeframe 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.

Angila Care Limited is a domiciliary care agency. It provides personal care to people living in their own homes the community. It provides a service to younger and older adults. CQC only inspects the service being received by people provided with 'personal care.' At the time of the inspection the service was providing 22 people with personal care.

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

Some people had experienced unsafe medicine management practices putting them at risk of harm. Staff understood how to keep people safe, however, some further work needed to be completed around risk assessments for specific medical conditions. There were enough staff to provide people with care and support, but some improvements needed to be made to the recruitment process.

Staff received training and received support from one of the managers. Staff provided people with support to meet their nutrition, hydration and health care needs. 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.

People received support from staff who were kind and caring. People were involved in making decisions about their care and were treated with dignity and respect. People were encouraged to be independent and their equality and diversity needs were respected.

A complaints procedure was in place and people said they would speak to the manager if they had any concerns. Concerns were not always being logged so there was no analysis of any emerging themes. This needed to be done so the registered manager could take any necessary action to resolve specific issues. People had their own individualised care plan which set out how they wanted staff to support them. More work needed to be completed in relation to how people wished to be cared for at the end of their life.

The provider did not have effective governance or auditing systems in place to ensure that people received safe care and treatment. This meant the provider was not identifying and rectifying short falls in the service. People were positive about the registered manager and the improvements they had made. The provider and registered manager were aware further improvements to the service needed to be made and were committed to providing a high-quality service.

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

Why we inspected

At the last inspection we were unable to give the service a quality rating. This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to the safe management of medicines and lack of effective audits.

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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Angila Care Limited is a domiciliary care agency. It provides personal care to people living in their own homes the community. At the time of the inspection, personal care and support was only being delivered to one person. Some sections of this report are short to protect the person's confidentiality.

There was no registered manager in post. A manager had been recruited and was in the early stages of registering with the Care Quality Commission. 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 small size of the agency and the care package being provided meant we were unable to gather enough evidence to support a quality rating.

A consistent team of staff provided care and support. They had received appropriate training and told us how well they worked as a team. Staffing levels were based on the needs of the person to keep them safe.

The provider had completed training in respect of the Mental Capacity Act (MCA) 2005 and understood their responsibilities under the Act.

Care plans were in place and staff followed these to ensure the person who used the service received the right care and support and was kept safe. This included support with personal care.

A complaints procedure was in place, but no concerns had been raised.

The provider and staff were committed to providing a personalised, individual service.