Access Care Solutions

Updated 3 November 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

This inspection was completed by two inspectors.

Service and service type

Access Care Solutions is a domiciliary care agency. It provides personal care to people living in their own houses, flats and specialist housing in Derby and Derbyshire. The service was supporting 13 service users with personal care at the time of the inspection.

Registered Manager

There was not a registered manager at the time of this inspection. The nominated individual who was also the provider was in the process of applying to become the registered manager. Both the provider and the registered manager 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 two days’ notice of the inspection. This was because we needed to be sure that arrangements could be made for us to review records in the office.

Inspection activity started on 30 August 2022 and ended on 8 September 2022. We visited the office location on 30 August 2022. Phone calls were made to six relatives on 1 September 2022. We made phone calls to care staff on 2 September 2022. We continued to review evidence the provider sent us until the 8 September 2022.

What we did before the inspection

We used information received about the service since it registered with the Commission. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR 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

We spoke with six relatives of people who used the care service. We spoke with the director, who was the nominated individual, and a senior carer. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with an additional three care staff on the telephone.

We reviewed a range of records including the relevant sections of three people’s care records and two people’s medicine administration record (MAR) charts. We looked at three staff files in relation to recruitment. We reviewed other records related to the management and governance of the service, including policies, staff training records and how checks were made on the quality and safety of services.

Updated 3 November 2022

About the service

Access Care Solutions is a domiciliary care service. It provides care for people living in their own houses and flats in Derby and Derbyshire. People are supported in their own homes so that they can live as independently as possible. CQC regulates the personal care and support. There were 13 people who received personal care at the time of the inspection. 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

Medicines were not always managed in line with good practice and records did not show people had always received their medicines as prescribed. Care plans contained details of what care people required however, there was limited information on other health conditions that people had and whether these had an impact on how care was provided. Not all the required pre-employment checks had been completed on staff when they started work. Checks to help ensure the quality and safety of services were not effectively operated. Records were not always complete or accurate.

People’s communication needs were assessed, and the provider told us they were able to provide information in different formats. Some relatives told us they would prefer access to their family members care plans and records in a non-digital format and they felt this option had not been presented to them. As such, some relatives did not feel fully engaged with the service. Other relatives spoke highly of their involvement and praised the communication with the service.

Care staff had been trained to understand how to support people with their end of life care needs. However, care plans for people’s end of life care contained limited information and did not record whether people had declined to discuss this issue.

People were supported to have maximum choice and control of their lives and care staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, people’s care records did not always accurately reflect what the provider told us about their capacity to understand their care.

There were enough staff to meet people’s needs and people received care from consistent care staff. Risks were assessed and actions had been identified on how to reduce these. This included how to reduce risks from infection, including from COVID-19. Staff were clear on what actions they needed to take, including the wearing of personal protective equipment (PPE). Systems were in place to help reduce the risks to people from abuse. Care staff had been trained and understood how to identify signs of potential abuse and how to report their concerns to help keep people safe.

Care staff told us they had received training to enable them to work effectively. Care plans for people’s nutrition and hydration needs were in place as needed. The involvement of other agencies in people’s care was effectively managed.

People felt well-supported and cared for with dignity and respect. People’s decisions about their care were respected and their choices and control promoted. People’s independence was supported.

People received a service that adapted to meet their changing needs. The service worked to help prevent people feeling socially isolated and care staff developed positive relationships with people. Systems were in place to help ensure any complaints were dealt with effectively and in line with the provider’s policy and procedures.

The provider looked to investigate any concerns raised with them and was considered open and approachable by care staff and relatives. The provider worked in partnership with others to achieve good outcomes for people.

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 19 November 2020 and this is the first inspection.

Why we inspected

This was a planned inspection based on the date of registration.

Follow up

We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.