Affection Care Services Ltd (Bucks)

Updated 19 May 2023

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 Health and Social Care Act 2008.

Inspection team

Day 1 of the inspection was carried out by 1 inspector, day 2 was carried out by 2 inspectors. An Expert by Experience made telephone calls to people and their relatives during the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

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

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 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 12 April 2023 when we requested initial information from the service. One Expert by Experience made telephone calls to people and their relatives on 18 and 19 April 2023. We visited the location's office on 14 and 24 April 2023. We continued to review evidence until 25 April 2023.

What we did before inspection

We reviewed 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. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During the inspection we met with the registered manager and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We checked a range of required records. These included care plans, staff personnel and training records, a sample of policies, procedures and other guidance, audits, observations of staff practice and medicines administration records. We spoke with 6 people who use the service and 6 relatives.

Emails were sent to all staff inviting them to provide feedback to us. We received responses from 8 staff. We contacted community professionals who are involved in the care of people who were supported by the service and received 2 replies.

Updated 19 May 2023

About the service

Affection Care Services Ltd (Bucks) is a domiciliary care service providing personal care to people in their own homes. At the time of the inspection 23 people were being supported who lived in the Princes Risborough or High Wycombe area of Buckinghamshire.

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

People were not routinely supported by staff who had been recruited using robust and safe processes. Not all staff had received pre-employment checks prior to supporting people. Staff received training either after their start date or well before their start date. Fifty percent of staff who provided feedback told us their training did not prepare them to support people safely. This was supported by comments from people.

People were not routinely supported with their medicines as prescribed. Pain relief medicine was given too soon to 1 person on a regular basis. Records relating to medicine were not always accurate.

People were supported by a service which needed more effective management systems and processes to drive improvement. Action plans developed and completed did not reflect the records we viewed. The provider did not ensure all regulations were met.

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; however, the policies and systems in the service could be improved to support this practice.

People told us they were happy with the support the care staff gave them. Comments included “I have no problems with the carers, they treat me with respect”, “They are kind and caring” and “I have nothing bad to say about the carers”.

Relatives told us “I find them [staff] good”, “They include me in the care and respect me” and “The manager is very responsive and nice”.

Staff had access to risk assessments and found they contained the information needed to reduce injury or harm to people/keep people safe from harm.

The service worked well with external social and healthcare professionals.

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 12 December 2019) and there were 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 the provider remained in breach of regulations.

Since the service has been registered with us on 9 October 2018 it has remained rated as requires improvement.

Why we inspected

We carried out an announced comprehensive inspection of this service on 28 and 29 October 2019. Breaches of legal requirements were found.

We have found evidence that the provider needs to make further improvements. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

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.

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

Enforcement and Recommendations

We have identified breaches in relation to medicine management, staff 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 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.