Angel Home Care Service Private Limited

Updated 2 June 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 on 22 and 27 February 2018 and was announced. The provider was given 24 hours' notice because the location provides a domiciliary care service and we needed to be sure that someone would be in the office. The inspection was undertaken by one inspector on both days of the inspection. An expert by experience conducted phone calls to people who used the service to gain their views. An expert by experience is a person who had personal experience of using or caring for someone who uses this type of service.

Before the inspection, we reviewed information we held about the service including statutory notifications sent to us by the provider about incidents and events that had occurred at the service. Statutory notifications include information about important events, which the provider is required to send us by law. We used this information to plan the inspection.

During the inspection we spoke with eight people who used the service, two relatives, a health and social care professional, the registered manager, two care coordinators and three staff members. We visited, with consent, the properties of three people receiving personal care from Angel Home Care Service Private Limited.

We looked at six people’s care plans and risk assessments. We reviewed four staff personnel files and records relating to recruitment, induction, training and supervision. We looked at three people’s medication records and a number of audits relating to medicines management, recruitment, safeguarding and quality assurance. We checked people’s feedback on the service including the timeliness of calls and whether people were involved in planning their care. We looked at health and safety and infection control and how risks were managed. We reviewed policies and procedures and business continuity planning.

Updated 2 June 2018

The inspection took place on the 22 and 27 February 2018. Because this service provides a domiciliary care service we gave them 24 hours’ notice that we were conducting the inspection to ensure there was someone available at the office to assist with the inspection.

Angel Home Care Service Private Limited is a domiciliary care agency. It provides personal care to people living in their own homes in the community. The service provides care to a range of people with different needs including older people, people living with dementia, learning disabilities, physical disabilities, mental health and sensory impairment. When we inspected the service, there were 51 people receiving domiciliary care. Calls to people’s properties ranged from 30 to 60 minutes per visit. Not everyone receives the regulated activity of ‘personal care’; The Care Quality Commission (CQC) only inspects the ‘personal care’ ; element of care. That is tasks related to personal hygiene and eating. We also take into account any wider social care provided.

Our last inspection of this service was on the 1 and 6 September 2016 and we found concerns relating to regulations 9, 11, 17, 18 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found that the provider was not carrying out adequate assessments of the needs and preferences of people using services. The provider was not acting in accordance with the Mental Capacity Act 2005. There were insufficient systems in place to assess, monitor and improve the quality of the service. Staff were not receiving appropriate training to enable them to carry out their duties and the provider had allowed two care workers to work before they had received a valid disclosure and barring certificate. The overall rating for the service was Requires Improvement. At this inspection, we found significant improvements had been made to the service and found the service to be ‘Good’ in all of our key questions; safe, effective, caring, responsive and well led.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and the timescale they needed to improve the key questions in safe, effective, responsive and well led. At this inspection, we found that the provider was completing comprehensive assessments of needs of people and documenting preferences in the care plan. The service was working in accordance with the Mental Capacity Act 2015 and assessing people’s capacity and making referrals to the local authority, when required. Audits and quality assurance systems were in place to assist in monitoring and improving the service. All new staff members had the required pre-employment checks in place before starting to work for the service. Staff members were receiving training appropriate to their job roles.

The service had a registered manager in post since February 2017. A registered manager is a person who has registered with the CQC 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 were protected from abuse. Staff followed the provider's and the local authorities safeguarding procedures to identify and report concerns about people's well-being and safety. Accidents and incidents were recorded, reviewed and analysed to determine patterns and take preventative measures.

Comprehensive assessments were carried out to identify any risks or potential risks to the person using the service. This included any environmental risks in people's homes, risks in the community and any risks in relation to the care and support needs of the person.

Staff were recruited safely and trained to meet people's individual needs. Wherever possible people were only supported by staff known to them.

There were enough staff assigned to provide support and ensure that people's needs were met.

Medicines was well managed and staff were fully trained in the safe administration of medicines.

Legible daily records were kept which documented what care and support each person had been given.

Care plans were regularly reviewed and were individual to the person.

People we spoke with told us that staff members were kind and caring.

Staff received support, regular supervision and attended training to enable them to undertake their roles effectively.

Staff were aware of the requirements of the Mental Capacity Act [2005] and the Deprivation of Liberty Safeguards [DoLS] which meant they were working within the law to support people who may lack capacity and who may need to be referred, under the court of protection scheme, through the local authority.

People were aware of how to raise concerns about the service provided and felt the registered manager was approachable.

There were quality assurance systems in place to make sure any areas for improvement were identified and addressed. This meant the service was working to improve the service for the benefit of people using it.

The registered manager and care coordinators were present in the office and we observed them interacting with staff in person and by telephone. They regularly visited people in their own homes and each person we spoke with knew who they were.