Akos Care Limited

Updated 18 May 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.

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 conducted by 1 inspector.

Service and service type

Akos Care Limited is a supported living service. This service provides care and support to people living in one 'supported living' setting, so that they can live as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people's personal care and support.

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 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.

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. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.

During the inspection

We spoke with 2 people using the service. We spoke with 1 member of support staff, the registered manager and the provider's nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed 5 people's care records including risk assessments and 3 staff files in relation to recruitment. We also reviewed other management records including staff files, medicines, complaints, safeguarding, activity plans and accidents and incidents.

Updated 18 May 2023

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.

Akos Care Limited is a supported living service providing personal care for 5 people, some of whom had learning disabilities. The service provides support to people living in their own home. At the time of our inspection there were 5 people using the service. Each person had their own bedroom, the bathrooms and kitchen were shared.

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

Right Support:

People's medicines were not managed safely. We found gaps in medicine records and staff had not been assessed for their competency in this area. People's communication needs had not been assessed; staff did not have guidance to support them to communicate effectively. People's risk management plans lacked details for staff to follow, this put people at risk of harm. People were supported by staff to pursue their interests; individual activity plans were in place for people.

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.

Right Care:

People’s care plans did not reflect their range of needs or preferences. Care plans were not personalised. People told us staff were kind and caring. We observed staff being respectful in their interactions with people, staff protected people’s dignity and right to privacy. There was no system to monitor how people were progressing with goals or reaching outcomes.

Right Culture:

The leadership team did not have clear oversight of the service. There was no quality assurance system in place. No audits of the quality of care had taken place. There was an improvement plan in place, but actions were outstanding. The provider did not involve people, staff and relatives in the running of the service. People, relatives, and staff were not given the opportunity to provide feedback, therefore improvements or changes could not be made to the quality of care. The provider carried out a needs assessment however it was not comprehensive and did not include information about nutrition and hydration or people’s communication needs.

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

The last rating for this service was requires improvement (published 25 January 2023) and breaches of regulations were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

Why we inspected

The inspection was prompted in part due to concerns received about the management of medicine, safeguarding procedures, governance and risk management plans. A decision was made for us to inspect and examine those risks.

Enforcement and recommendations

We have identified breaches in relation to safe care and treatment, good governance and person-centred care. 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.

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