Apex Prime Care - Hailsham

Updated 1 October 2022

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector 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.

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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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. At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because we wanted to be sure there would be staff at the office available to speak with us.

Inspection activity started on 9 August 2022 and ended on 12 August 2022. We visited the location’s office on 9 August 2022.

What we did before the 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 of this information to plan our inspection.

During the inspection

During the inspection we spoke to 14 members of staff including, the registered manager, the supervisor, the training manager, two care co-ordinators, one senior carer and eight carers. We spoke with 14 people that used the service, eight relatives and seven professionals.

We looked at a range of documents including seven care plans and associated risk assessments. Medication administration records (MAR), six staff files, and documents relating to audits and quality assurance processes. We looked at safeguarding files, accident and incident records and policies about complaints, whistleblowing and contingency planning.

Updated 1 October 2022

About the service

Apex Prime Care – Hailsham is a domiciliary care agency. The agency provides care to people living in their own homes. At the time of the inspection, care was being provided to 90 people. Some people lived with dementia and some people had support needs relating to their mobility or other health support 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.

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

The timings of people’s care calls varied and did not consistently match the times recorded in people’s weekly rotas. This had an impact on people with some people having to reschedule health appointments and social events. A person told us, “My morning call often comes so late I miss meeting up with my friends and I can’t plan to see them.” A system was in place for staff to call the office when running late however this system was not working. People told us that when raising issues or complaints, their calls were not well managed and that they felt ‘fobbed off’ when wanting to speak with managers.

Some care plans lacked risk assessments for people that had specific health needs for example, people living with epilepsy. Some other risk assessments lacked detail and only had general information about particular health conditions for example, Parkinson’s disease. People told us they were unsure how to contact the registered manager and, in most cases, did not know who the registered manager was.

People’s communication needs were met and people’s care plans contained details of their likes, dislikes and daily routines. Some staff had completed end of life training and were able to tell us the important aspects of care and support for people at that time of their lives.

Systems were in place for auditing all key areas of the service and this was overseen by the registered manager. People had opportunities to provide feedback about the service. This was done each day to carers if needed and more formally through an annual questionnaire. The registered manger had developed positive working relationships with partners.

People were protected from harm by systems and processes that had been put in place to safeguard people. People told us they felt safe and staff were able to tell us the steps they would take if they felt a person was at risk and in need of protection. Risks to people had been assessed in most cases with clear guidelines in place for staff to follow if required. Staff had been recruited safely and there were enough staff to support all care calls. Some people needed support with their medicines and this was provided by trained staff with regular competency checks on staff, carried out by supervisors. Infection prevention and control measures were in place and staff had access to and correctly used, personal protective equipment (PPE). Accidents and incidents had been recorded and any themes or trends and lessons learned shared with all staff.

The registered manager carried out pre-assessments for people and ensured that staff had the necessary skills and training to be able to support people. Pre-assessment paperwork formed the basis of people’s care plans which were then subject to regular reviews. New staff received a comprehensive induction which was supported by ongoing supervision meetings, appraisals and regular training. People’s nutrition and hydration needs were met. Staff sometimes supported people to meet health and social needs appointments. 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.

People told us that staff were kind and treated them with respect and dignity. People were supported to make choices about their care and support needs and were encouraged to be impendent and to take positive risks with their daily routines.

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 the service at the previous premises was good, published on 8 August 2018.

Why we inspected

This was the first inspection for this service following a change in office address.

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.