Admiral Care Limited

Updated 6 June 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

This inspection was carried out by 1 inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

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.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 4 April 2023 and ended on 13 April 2023. We visited the location’s office on 4 and 6 April 2023.

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. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 7 people and 8 relatives about their experience of the care provided. We spoke with 15 staff including 9 care staff, a care team leader, compliance lead, training lead, director, registered manager and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We looked at the care records of 7 people and multiple medication records. A variety of records relating to the management of the service were reviewed. These included policies and procedures, records of accidents or incidents, staff training and quality assurance records. Following the inspection, the registered manager provided us with information and other documents to support our inspection.

Updated 6 June 2023

About the service

Admiral Care Limited is a domiciliary care service providing personal care to people in their own homes. The service provides support to older people and younger adults some of whom may be living with dementia, a mental health condition and/or a physical disability or sensory impairment. At the time of our inspection there were 57 people using the service.

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

People and relatives we spoke with told us they received safe care. However, records to support the delivery of safe care, were not always complete, up to date or accurate.

Action was taken when safeguarding allegations and concerns were raised. However, these concerns were not always shared promptly with the local authority safeguarding team or notified to CQC. Sharing this information is required to help protect and monitor people’s safety.

Information about people’s medicines and the management of medicines was not always comprehensive or up to date. This meant staff did not always have access to the guidance necessary for the safe management of people’s medicines.

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. However, the provider’s process to show how decisions had been made in people’s best interests required improvement. We have made a recommendation about this.

The governance system had not identified the concerns we found. Policies required updating and incidents requiring notification to the CQC had not always been submitted.

Staff understood how to protect people from the spread of infections. Although at times the service was short staffed, management staff provided care to ensure people did not experience missed or shortened calls. The provider acted when things went wrong, and improvements were made as a result of lessons learnt.

People and relatives spoke highly about the quality-of-care people received. Staff told us they received the support and training they needed to carry out their role. Staff worked in partnership with other health and social care professionals to achieve positive 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 and update

The last rating for this service was good (published 31 July 2018).

Why we inspected

We received concerns in relation to allegations of neglect and unsafe practice. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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

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

Enforcement and Recommendations

We have identified breaches in relation to records concerning people’s care, management of people’s medicines, governance arrangements and notification of incidents to CQC 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. 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.