Angel Approved - Care at Home

Updated 10 March 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 1 inspector with support from an assistant 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 and specialist housing.

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. They were also the provider and sole director of the company.

Notice of inspection

This inspection was announced.

We gave a short period notice of the inspection because we wanted to get consent from people and relatives to be contacted by an inspector for feedback. We also needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 5 January 2023 and ended on 25 January 2023.

What we did before the inspection

We reviewed information we had received about the service since they were registered. We sought feedback from the local authority who work with the service.

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 1 person who used the service and 4 relatives about their experience of the care provided. We spoke with 12 members of staff including the registered manager, the deputy manager, the care consultant, the relationship executive, the roster coordinator and 7 health care assistants. We also spoke with 4 professionals.

We reviewed a range of records. This included 8 people's care records. We looked at 3 staff files in relation to training, recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Inspection activity started on 5 January 2023 and ended on 25 January 2023 with a visit to the office.

Updated 10 March 2023

About the service

Angel Approved - Care at Home is a domiciliary care agency providing personal care to people living in their own homes or specialist housing. The service provides support to older people, often who live with dementia. Some people require support with their mobility. At the time of our inspection there were 14 people receiving personal care.

Not everyone who used the service received personal care. 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

We found some areas for improvement regarding audit processes, people’s documentation, partnership working and understanding of reporting incidents. We also discussed concerns around closed culture and personal relationships between staff and the registered manager.

Although we identified these issues, staff and professionals spoke highly of the registered manager. One staff member said, “Management are really responsive, very easy to talk to and willing to listen.” Other staff talked about a strong team working ethic. One staff member said, “We all get on and are comfortable discussing things with each other. We worry about the same things.”

The registered manager was aware of current concerns within the care sector and sought external links with other services to improve quality of care.

There were enough staff to meet people’s needs and staff knew people and risks to their wellbeing. One relative told us, “They always arrive within times, apart from the odd occasion which is unusual. I think they are very reliable.” Staff had all received training in safeguarding, could recognise signs of abuse and tell us actions they would take if they had concerns. Medicines were given safely.

Staff were trained and knowledgeable. They engaged with professionals in the community, to ensure individual needs had been met. One professional said, “They always listen and take on board my professional recommendations.” Staff felt well supported in their roles with an induction and regular checks on their wellbeing.

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.

Feedback about staff from a person and relatives was positive. Staff were described as kind, caring and compassionate. People’s dignity, privacy and independence was promoted and respected.

People received personalised care. Their views, choices and preferences were at the centre of all support. Staff knew and understood how to communicate with people in line with their support needs and preferences. People knew how to complain if there were any issues and received a timely and effective response. People supported at the end of their lives were cared for with compassion. Their choices were respected by staff and action taken to ensure a comfortable and pain free death.

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 4 April 2022 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement and Recommendations

We have identified 1 breach of regulations in relation to auditing processes, partnership working and lack of transparency at this inspection.

There was also a breach of the Care Quality Commission (Registration) Regulations 2009 where the provider had not consistently reported incidents to us.

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. 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.