Archived: Annette's Care Limited Domiciliary

Updated 2 December 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 13 and 27 October 2016 and was announced. The provider was given notice because the location was a domiciliary care agency and we needed to be sure that someone would be available. The inspection team consisted of two inspectors.

Before our inspection we reviewed the information we held about the service. We reviewed notifications of incidents that the provider had sent us since the last inspection. A notification is information about important events, which the service is required to send us by law.

After the inspection, we spoke with five people who used the service and two relatives. We also spoke with three members of staff, the deputy manager and the registered manager, who was also the registered provider. We also contacted three healthcare professionals, who knew the service well, for their views about the service. On the second day of our visit the registered manager and deputy manager were unavailable. Therefore we were supported by a senior staff member of another of Annette’s Care Limited services.

We looked at five records related to people’s individual care needs. This included support plans, risk assessments and daily monitoring records. We also looked at three staff recruitment files and records associated with the management of the service, including quality audits.

Updated 2 December 2016

This was the first inspection for Annette’s Care Limited since they registered with the CQC in March 2016.

We received information of concern in relation to the service and as a result, carried out a comprehensive inspection on 13 and 27 October 2016. The concerns included that staff only stayed for ten minutes at a thirty minutes call and only one staff arrived for an allocated call where two staff were needed. We also received concerns that there was unreported and un-investigated theft, the registered manager completing staff medication training for them, no on call system and no protective gloves or aprons available.

We looked at these concerns during this inspection. People confirmed staff stayed the allocated time for each visit, never rushed and if required two staff members turned up to assist with supporting people. The registered manager said they had not received any reports of items stolen of taken from people’s home. People confirmed they had not had any items stolen or go missing from their homes. Staff confirmed they had completed their own medicines training and understood the importance safe administration and management of medicines.

Annette’s Care Limited Domiciliary provides personal care in people’s homes to adults within Plymouth and Cornwall. On the day of the inspection Annette’s Care was providing personal care support to 17 people including those with physical disabilities and people living with dementia.

The service had a registered manager, in post, who was also the registered provider. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People received personalised care and had care plans in place to provide guidance and direction to staff. This helped to ensure the support they received reflected their wishes and preferences. People’s care plans were currently being updated following advice from a healthcare professional from the commissioning authority, to ensure they were reflective of their up to date care needs. One person said; “I’ve had them for over two years and am quite happy” and “There isn’t anything they can improve. If there is, we talk about it. They listen.” A staff member commented; “It makes me proud to work for them and know people are so well cared for.”

People had risk assessments in place to help ensure they were protected and kept safe. The registered manager was taking steps to review and update people’s risk assessments.

People were supported by sufficient numbers of staff to keep them safe and meet their needs. Staff were recruited safely, to ensure they were suitable to work with vulnerable people. People told us overall, staff arrived on time. Staff said they had adequate travelling time between visits.

People were protected from avoidable harm and abuse because staff had received safeguarding training and knew what action to take if they suspected someone was being abused, mistreated or neglected. Staff understood the principles, had a good knowledge on how to report any concerns and described what action they would take to protect people against harm.

Staff were protected by a lone working policy and the provider had emergency plans in place to help, in the event of staffing difficulties.

People were protected from the spread of infection. People told us staff followed infection control practices and that staff wore gloves and always left their homes clean and tidy.

People’s medicines were managed safely, staff received training and people had care plans in place to provide guidance and direction as to how they would like their medicines to be administered.

People received care from staff who had undertaken training to be able to meet their needs. People were positive about the staff’s ability to meet their needs. Staff were complimentary of the training and support they received.

People’s consent to their care and support was sought. The registered manager and some staff had completed training in the Mental Capacity Act. Some staff had an understanding of the Mental Capacity Act 2005 (MCA). Further training was planned.

People who had support with meals were encouraged and supported to maintain a healthy balanced diet.

People told us they received support from excellent and kind staff. People were supported by a small group of staff which helped to ensure continuity of care and develop personal relationships. Staff spoke fondly of the people they supported and told us they liked to go the extra mile. People were involved in decisions relating to their care, and support, and people told us their privacy and dignity was respected.

People’s independence was promoted and staff took opportunities to encourage people to do as much for themselves as possible.

People had a pre-assessment before joining the agency to help ensure the service could meet their needs.

People, their relatives and staff were encouraged to be involved in the running of the service and help drive continuous improvements. This helped ensure positive progress was made in the delivery of care and support provided by the service.

The registered manager sought verbal feedback from people and encouraged people to share their concerns and complaints. The registered manager said any complaints or concerns would be investigated thoroughly and used the outcome as an opportunity for learning to take place.

There were effective quality assurance systems in place to help drive improvements and ensure positive progress was made in the delivery of care and support provided by the service.

There was evidence of leadership and governance in place via a management team, who were passionate about delivering a quality service. Staff felt motivated and well supported.