Athlone Care

Updated 28 October 2021

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 Care Act 2014.

Inspection team

The inspection was carried out by two 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.

The Expert by Experience made telephone calls to people and their relatives to gain their views of the service they received.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had two managers registered with the Care Quality Commission, one of whom was the provider. This means that the registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The provider was not available during the inspection, so the reference to registered manager in this report does not refer to the provider.

Notice of inspection

This inspection was announced. We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 19 August 2021 and ended on 2 September 2021. We visited the office location on 19 August 2021. The Expert by Experience called people and their relatives on 20 August 2021 and we spoke with staff on the telephone on 2 September 2021.

What we did before the inspection

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We reviewed the concerns we had received and had contact with the local authority safeguarding teams. We used all this information to plan our inspection.

During the inspection

We spoke with four people who used the service and six relatives about their experience of the care provided. We spoke with seven members of staff including the registered manager, the quality assurance lead, senior care workers and care workers.

We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at rotas, training data, concerns, staff meeting minutes and quality assurance records.

Updated 28 October 2021

About the service

Athlone Care is a domiciliary care agency, providing personal care to 58 people at the time of the inspection. 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.

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

The service people received was not always safe. Concerns had been raised with CQC before the inspection in relation to the timings of people’s care and the hours staff were working. We found evidence the concerns were founded. The provider could not be sure people were receiving the care they needed at the right times as records were not closely monitored.

Systems to monitor the quality and safety of the service did not evidence the provider could make and sustain improvements to people’s experience of care in their home. There were mixed views from people and their relatives about the responses they received from the office and management team.

Complaints and concerns needed a more robust approach to evidence people were listened to and action was taken when they raised concerns about their care. We have made a recommendation about this.

Plans were in place to mitigate individual risks. People’s medicines were administered and managed safely by staff. Staff understood their responsibilities in keeping people safe and reporting concerns if they had them, including accidents and incidents. The provider kept staff up to date with the latest guidance around infection control through meetings and social media messaging.

People, and their relatives where appropriate, were involved in planning their care. Care plans provided the information staff needed to provide people’s care in the way they wanted it.

Staff we spoke with were positive about the support they received from the provider and registered manager, saying they could speak to them about anything and were confident about their response. The provider and registered manager engaged well with local services and commissioners.

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

Rating at last inspection

The last rating for this service was good (published 5 January 2019). The service has now deteriorated to requires improvement.

Why we inspected

We received concerns in relation to staffing concerns including missed and late care visits and the providers response to complaints and concerns. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvement. Please see the safe, responsive and well-led sections of the full report.

You can see what action we have asked the provider to take at the end of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Athlone Care on our website at www.cqc.org.uk.

Enforcement

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.

We have identified one breach of regulation, in relation to accurate record keeping and oversight and monitoring at this inspection.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.