ApproCare

Updated 1 August 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

The inspection was conducted by an inspector.

Service and service type

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

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

This inspection was announced. We gave the service 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 31 March 2023 and ended on 16 June 2023. We visited the location’s office on 31 March 2023.

What we did before the inspection

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.

What we did before inspection

We reviewed information we had received about the service since the last inspection. This included feedback from people who told us they had used the service and people who told us they had worked for the provider. We used all this information to plan our inspection.

During the inspection

During our site visit we spoke to the registered manager and office administrator. We reviewed a broad range of documents on site and remotely including 6 care plans, quality assurance reports and recruitment and training records. We spoke to a local commissioner of care services for Kent, 5 people who use the service and 5 staff members.

Updated 1 August 2023

About the service

ApproCare is an independent domiciliary care agency which provides personal care and support for adults in their own homes. People receiving care and support had a range of needs including, older people, people living with dementia, people with poor mental health, people who misuses alcohol and or drugs, people with eating disorders, people with a physical or sensory disability and people who have a learning disability and or autism.

At the time of the inspection the service was not supporting people who misuses alcohol and/or drugs or people with eating disorders.

The agency provides care for people in the local Isle of Sheppey area and Sittingbourne. At the time of our inspection, they were supporting 59 who received support with personal care tasks

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: Peoples needs were not always identified and recorded. Staff supported people to play an active role in maintaining their own health and well being. Staff supported people with their medicines in a way that promoted their independence.

Right Care: People’s care, treatment and support plans did not always reflect their range of needs. Staff knew how to protect people from poor care and abuse. Some people told us they received kind and compassionate care. Staff protected and respected people’s privacy and dignity.

Right Culture: Staff turnover was high, which meant some people did not always receive consistent care from staff who knew them well. There were not effective systems and processes in place to ensure the quality and safety of services. Some staff did not feel valued but all staff we spoke with told us they believed their work was important and they enjoyed caring for people.

The last rating for this service was good (Report published 28 March 2019).

Why we inspected

The inspection was prompted in part due to concerns received about staffing and organisational culture. A decision was made for us to inspect and examine those risks. We undertook a focused inspection to review the key questions of safe and well-led only. Based on our inspection of safe and well led we found the service required improvement.

You can see what action we have asked the provider to take at the end of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for ApproCare on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to the number of trained staff available to provide care, the assessment of people’s needs, how this is communicated to people, how risks to them are identified, shared and addressed. We also found poor governance systems and processes for the service.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.