Background to this inspection
Updated
25 May 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.
Inspection team
This inspection was carried out 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.
This service is also registered for supported living but was not carrying out any regulatory activity for this service type at the time of the inspection.
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 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.
The inspection activity started when we visited the office on 30 March 2022 and ended on 11 April 2022 when we received feedback from staff and people using the service.
What we did before the inspection
Before the inspection we reviewed the information we had received about the service. This included the provider’s registration assessment record.
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
We used all this information to plan our inspection.
During the inspection
We spoke with the registered manager and reviewed records such as the care plan and risk assessments in place. We looked at the call monitoring system support and medicines records. We viewed the staff recruitment records for two staff.
We spoke with one staff member by phone on 4 April 2022 and tried unsuccessfully to speak with another staff member.
We asked for feedback from the person using the service which we received by email on 11 April 2022.
Updated
25 May 2022
About the service
Avant Garde is a domiciliary care service in the London Borough of Greenwich, providing personal care and support to people living in their own homes. On the day of the inspection there was one person using the service.
People’s experience of using this service and what we found
Medicines were not always safely managed in line with best practice. Risks in relation to people’s health needs were not always identified or assessed or advice from health professionals sought when needed. Assessments of people’s needs were not sufficiently robust.
We have made a recommendation for the provider to consult best practice guidance around the assessment of people's needs.
The person using the service was happy with the support provided and felt safe with staff. Staff knew the action to take if they suspected abuse or neglect had occurred.
There were arrangements to make sure people were protected from the risk of infection through safe infection control practice.
Staff were supported in their roles through training and regular supervision. Staff offered support to ensure people could receive a balanced diet of their choice.
The person using the service had a small staff team who knew them well and they liked. Staff treated people with care, consideration dignity and respect. There were arrangements to ensure people were involved in making decisions about the support they received.
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.
The person using the service received person centred care that met their wishes. They knew how to complain if they needed to.
Staff spoke positively about the support they received from the registered manager. The registered manager understood their responsibilities under the CQC regulations. They carried out spot checks on staff and audited records to oversee the quality and safety of the service. Feedback was sought from people and staff through regular contact and surveys.
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
This service was registered with us on 26 March 2020 and this is the first inspection.
Why we inspected
We inspected to provide a rating for this service.
Enforcement and Recommendations
We have identified breaches in relation to identifying risks, the management of medicines and the systems to monitor the quality and safety of the service 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 of the service.
We will continue to monitor information we receive about the service, which will help inform when we next inspect.