Archived: Care Avenues Limited

Updated 19 April 2019

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.

The site inspection took place on 12 and 14 December 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because it is a domiciliary care agency and we needed to be sure that the provider was about. Inspection activity started on 10 December 2018 and ended on 18 December 2018. It included telephone calls to people who use the service and staff. We visited the office location on 12 and 14 December 2018 to see the provider and office staff; and to review care records, policies and procedures. The inspection was to follow up on our previous inspection findings and to check the necessary action to improve the quality of care and reduce the risks to people had been completed.

The site inspection was carried out by an inspector and an assistant inspector and telephone calls were made to people and their relatives by two Expert by Experience’s. An Expert by Experience is a person who has experience of using or caring for someone who uses this type of care service.

As part of the inspection, we reviewed the information we held about the service, including notifications. A notification is information about events by law the registered persons should tell us about. We also reviewed other information we held about the service this included action plans the provider was required to send us as part of the enforcement action we had taken at our last inspection.

We spoke with seven people who used the service, four relatives and seven members of care staff. We spoke with the provider and three office staff. We reviewed the care records of ten people including their medicine records and three staff files, which included pre-employment checks and training records. We looked at other records relating to the management of the service including complaints logs, incidents, audit checks and scheduling of calls.

Updated 19 April 2019

This inspection took place on 12 and 14 December 2018 and was announced. Care Avenues Limited are registered to provide the regulated activity of personal care. The service 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 and younger disabled adults.

Not everyone using Care Avenues Limited receives 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 were 20 people receiving regulated activity at the time of our inspection.

At our last inspection in March 2018 we identified improvements were needed under the key questions of is the service safe, effective, caring, responsive and well-led. We identified three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Following our last inspection, we asked the provider to complete an action plan to show what they would do and by when, to improve these key questions to at least good. We also issued a Notice of Decision to place conditions on the provider’s registration. A Notice of Decision is one of our enforcement powers.

This inspection took place to follow up on our previous findings. We returned to check the necessary action had been taken to improve the quality of care and reduce any risks to people. At this inspection we found that the required improvements had not been made. The provider continued to be in breach of three regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Therefore, the overall rating for the service remains as ‘Inadequate ‘and will remain in ‘special measures’. For adult social care services, the maximum time for being in special measures will be no more than 12 months. We are deciding our regulatory response to this and will issue an updated report once this decision is made.

The service did not have 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.

Care and risk assessment documentation were not reflective of people’s needs and did not provide staff with sufficient guidance to deliver personalised care. Not all the staff had received adequate training to deliver their roles effectively.

There were no effective quality assurance systems in place to assess, monitor and improve the service. Analysis of incidents and concerns raised had not taken place to identify patterns or trends that might reduce the risk of re-occurrence.

People told us staff were kind, caring and treated them with dignity and respect when providing care. People were supported to remain as independent as possible. People were aware of how to raise concerns or complaints and the provider had a system in place to investigate complaints.

Pre-employment recruitment checks had been completed for new staff before they began work. Staff enjoyed working for the service and felt the management were approachable.