Apex Prime Care - Oldham

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

The inspection was carried out by 3 inspectors and 2 Expert by Experiences. 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.

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 under 24 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be available to support the inspection.

Inspection activity started on 5 April 2023 and ended on 18 April 2023. We visited the location’s office on 5 April 2023 and 11 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 11 people who used the service and 17 relatives about their experience of the care provided. We spoke with 17 members of staff including the registered manager and care workers.

We reviewed a range of records. This included 9 people’s care records and multiple medication records. We looked at records in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

Updated 6 June 2023

About the service

Nobilis Care Oldham is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older people and younger adults with various needs. At the time of this inspection 200 people were 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

Medicine recording systems were not robust. Medicine records were not always complete and some were poorly maintained. People’s risk assessments in relation to their care lacked detail and were not always updated.

We received mixed feedback from people and their relatives in relation to people receiving regular staff members for their visits.

Auditing systems were not always robust and auditing processes had not picked up on the discrepancies we found during this inspection. Governance systems required improvement.

Staff had received training in safeguarding people. People were protected from the risks of abuse and staff were trusted to keep them safe. 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.

Recruitment checks were robust to ensure staff were suitable to work with vulnerable adults. The provider had systems in place to monitor staffing levels and ensure people received their visits. Staff received training in infection prevention and control and personal protective equipment [PPE] was readily available to them.

Person-centred care was promoted. The registered manager and staff demonstrated a commitment to people, and they displayed person-centred values. The registered manager worked effectively in partnership with other health and social care organisations and networks to build connections and achieve better outcomes for people using the service.

Staff praised the registered manager and the wider management team within the service, they felt supported in their roles.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection

The last rating for this service was good (published 12 May 2021).

Why we inspected

We received concerns in relation to the management of medicines, staffing arrangements and management support. 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.

We found no evidence during this inspection that people were at risk of harm from these concerns. However, we have found areas that needed improvement in relation to record keeping and auditing functions.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

Enforcement

We have identified a breach in relation to maintaining accurate records and operating robust auditing systems.

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.