Angels Care Agency Limited

Updated 19 February 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 Care Act 2014.

Inspection team

The inspection was carried out by one inspector and one 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

The service had a manager registered with the Care Quality Commission. 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 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 7 January 2022 and ended on 24 January 2022. We visited the office location on 11 January 2022 and 12 January 2022.

What we did before the inspection

We reviewed information we had received about the service since it was registered with the Care Quality Commission on 17 September 2020. We also sought feedback from the local authority.

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 used all of this information to plan our inspection.

During the inspection

During the inspection we spoke with three people using the service and received feedback from five family members and one advocate. We also spoke with seven members of staff, including four care workers, a care coordinator, administrative support worker, and the registered manager, who was also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also received email feedback from one additional member of staff.

We reviewed a range of records. This included five people's care and support plans, these people's daily records, as well as medicines records where they received support with this task. We looked at five staff files in relation to recruitment, training and supervision. We reviewed a variety of records relating to management of the service, including policies and procedures, quality assurance surveys, and evidence of staff COVID-19 testing.

After the inspection

We continued to review records shared electronically and continued to seek clarification from the provider to validate evidence found. We received feedback from five professionals during the inspection process.

Updated 19 February 2022

About the service

Angels Care Agency Limited is a service providing care and support to people in their own home. At the time of the inspection the service was supporting nine people. This included both younger adults and older people.

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

People were safeguarded from risks of abuse and staff understood their responsibility to report signs of abuse or neglect. We have made a recommendation about the policies and procedures in place to inform staff about types and signs of abuse. We also made recommendations in relation to the safe management of medicines and risk assessments for people using the service. Our inspection also identified concerns regarding staff testing for COVID-19.

We found management systems were not fully effective in monitoring the quality and safety of the service. The service undertook regular quality assurance questionnaires, and results returned from people and families indicated a high level of satisfaction with the service. We found other governance systems in place, such as a monthly compliance audit, had not been fully effective in monitoring the service. For example, audits had failed to identify all of the concerns we found in relation to risk assessments and medicine records.

We have made a recommendation in relation to systems in place to evidence staff had demonstrated the knowledge and skills to perform their roles. The service kept records of staff training, shadowing and supervisions and the registered manager was confident staff were working safely and effectively. People and relatives also felt staff had the required training to support them. One person’s representative explained, “From a user perspective the staff are trained. They have a consistent approach. Files and paperwork are always up to date. Any concerns and they will contact us. Communication is excellent.”

People and relatives felt the service was safe, and people benefited from consistent continuity within staff rotas. People told us staff arrived on time and stayed the required length of time to support them. People received person-centred care from staff who understood their needs. Staff could speak in detail about people they support, with knowledge of people's likes, preferred routines and what was important to people. One person advised, “I have the same carers. I need consistency or care doesn’t work. [Staff member] has gone above and beyond – absolutely amazing.”

People's needs were assessed, and care plans provided an overview of people's physical, social and emotional needs. Where appropriate, people were supported by family members or an advocate as part of care assessments to make decisions about their care and support. A relative commented, “We were involved in the assessment. [Person’s name] can make some decisions. We try to involve him where possible.”

People were supported by staff who were kind and caring. A relative advised, “The carers are very lovely people, I can tell by the way they treat [relative]. [Staff member] is very lovely, the way she talks to her and the way she treats her. [Relative] will often ask for her.” A person using the service added, “Carers are lovely people. Always willing to help and will tackle anything I ask them to do for me.”

The service placed an emphasis on supporting people’s independence and where necessary had requested additional funding for people’s care to enable staff to have sufficient time to support people. This meant people could try to achieve day to day tasks more independently without feeling rushed. A person who was supported to self-medicate explained staff only helped with tasks they could not do themselves, such as loosening the lids on medicine bottles. A relative also commented, “Carers take their time to shower [relative]. He is not rushed.”

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 in the service supported this practice. We recommended the service monitors and reviews their processes for seeking consent, to ensure records fully reflect how people have been consulted in relation to their care, to ensure the service meets legal requirements and follows relevant best practice guidance.

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

Rating at last inspection

This service was registered with us on 17 September 2020 and this is the first inspection.

Why we inspected

This was a planned inspection following the service's registration with CQC.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective and Well-led sections of this full report.

The provider responded to our feedback and agreed to make improvements to systems and processes in place in relation to assessing risk, COVID-19 testing, and management systems for monitoring quality and safety.

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.