AZ Caring Services Ltd

Updated 29 September 2020

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.

This was a focused inspection to check whether the provider had met previous breaches of regulation 12 safe care and treatment, regulation 16 managing complaints, and 17 good governance of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The previous shortfalls related to recording the administration of medicines, recording risks to people’s health and welfare, the management of complaints, and ineffective quality assurance systems.

Inspection team

The inspection was conducted by one inspector

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 was also registered for supported living but this was not currently being used.

The service had a manager registered with the Care Quality Commission who was also the registered provider. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave 48 hours notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 1 September 2020 and ended on 3 September 2020. We visited the office location on 1 September 2020.

What we did before the inspection

We reviewed the information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider/registered manager was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.

During the inspection

During the site visit we spoke with the provider/registered manager, and assistant manager. We reviewed a range of records. This included two peoples care records, medication records, two staff recruitment and supervision records. We also reviewed the complaints record and other records relating to the management of the service, including policies and procedures.

After the inspection

After the site visit, we spoke with four relatives of the four people receiving a service. We spoke with three carers, and a health professional who has regular contact with the service. We continued to seek clarification from the provider to corroborate evidence found. We looked at training data, staff and management meeting minutes, and survey analysis.

Updated 29 September 2020

About the service

AZ Caring Services Ltd provides personal care to older and younger adults in their own homes, who require assistance with personal care needs or have need of stimulation and activity. The service can support some people on a 24-hour basis if needed. At the time of our inspection the service was supporting four people with their personal care needs.

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.

The registered provider and registered manager are the same person so we will refer to them throughout the report as the provider/registered manager.

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

People felt safe with the staff entering their homes. Relatives were very complimentary telling us "They have the right attitudes, these carers are so superior to others we've experienced." Relatives felt that the agency provided holistic care to them and their family member. One said "They've taken a lot of weight off of my shoulders, I have come to rely on them." Another said, "They stepped in and sorted out some issues we had in lockdown." Staff were trained to understand, recognise and act on abuse to keep people safe. The provider had acted to address previous shortfalls and improved systems and processes to ensure the service offered a good quality of care and that people were safe and well cared for.

Accidents and incidents were minimal but were monitored and responded to appropriately. Learning from when things went wrong was shared with staff to inform their practice.

There were enough staff to support people receiving the service. Staff were recruited safely and received appropriate training and supervision.

Staff had received additional infection control training to support their understanding of the Covid 19 pandemic. They were provided with personal protective equipment and they and relatives confirmed this was worn on every visit to keep everyone safe and to reduce risks of infection.

Medication was managed safely and improvements had been made to the way in which medicines administered were recorded. Regular counts were made of the amounts administered, this was to check that people were receiving the right level of medication when they needed it. Staff were trained in medication administration and their competency was checked annually.

Relatives told us that staff were kind and caring. Improvements had been made to make people and relatives aware of the complaints process. Relatives told us they knew how to raise issues and felt listened to. They and staff were surveyed annually for their views about the service but they were also contacted regularly to gauge their satisfaction. Feedback was used to inform service improvements.

Relatives told us that the provider/registered manager and staff were very approachable. Staff thought the provider/registered manager fostered an open and transparent culture. Staff meetings were held to discuss important changes and enabled staff to express their views. Regular audits were carried out to give the registered manager oversight of service quality and any emerging shortfalls. A new electronic system was effective in alerting the provider and office staff of any concerns quickly. Going forward there were plans to improve use of the system to help in the auditing process. The new system would also allow people and relatives to read their care notes with appropriate password protection.

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.

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 31 May 2019) and there were multiple breaches of regulation. 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 improvements had been made and the provider is no longer in breach of regulations.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-Led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires improvement to Good. 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 AZ Caring Services Ltd on our website at www.cqc.org.uk.

Enforcement and Follow up

Since the last inspection we recognised that the provider/registered manager had failed to display their rating. This was a breach of regulation and we issued a fine. The provider/registered manager accepted a fixed penalty and paid this in full. 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.