Ace Homecare London

Updated 10 June 2022

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 two inspectors and one Expert by Experience who contacted people who used the service and relatives. 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

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

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 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 all this information to plan our inspection.

During the inspection

We spoke with 14 relatives about their experience of the care provided.

We spoke with five members of staff including the registered manager, care coordinator, and care workers. We have also received written feedback from six care workers

We reviewed a range of records. This included six people’s care records and medicines management policies and procedures. We looked at five staff files in relation to recruitment and staff supervision and reviewed a variety of records relating to the management of the service, including policies and procedures.

Updated 10 June 2022

About the service

Ace Homecare London is a domiciliary care agency providing personal care to people living in their own homes. At the time of our inspection 68 older people or people with dementia received personal care support from Ace Homecare London.

Not everyone who used the service received personal care. Care Quality Commission (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

Whilst most people spoke positively of the level of care and support, they received from Ace Homecare London, we found weaknesses in risk assessments and risk management, care planning and governance arrangements. Risk in relation to people receiving personal care were assessed, however the service failed to provide clear plans and guidance in how to manage such risks. Care plans were in place, however, there was a lack of person specific detail in how people’s needs were best met. The service quality assurance system was not fully effective and did not address the shortfalls we found during our inspection.

People who used the service were safe from harm and abuse and care workers demonstrated a clear understanding of their role when reporting and responding to abuse. Overall staff were recruited safely, and sufficient staff were deployed to meet people’s needs. People who used the service were protected from infections such as COVID-19. The service documented and analysed accidents and incidents to improve outcomes for people who used the service.

Care workers had access to training and received support from their line manager through supervision and appraisals. Peoples’ needs were assessed, and care plans were based on such assessments. When people received support around eating and drinking this had been documented. Relatives of people who used the service supported people to access health care professionals such as doctors and hospitals However, relatives told us that care workers would contact clinicians if this was required. 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.

Complaints and concerns raised by people were investigated and where necessary actions were taken to improve outcomes for people who used the service.

The service had a clear management structure and care workers and staff were clear of their responsibilities. Feedback in respect to the management and office staff was positive and care workers told us that the registered manager listened to them and was supportive.

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 20 April 2021).

Why we inspected

We received concerns in relation to the support people received to minimise the risk of theme developing pressure ulcers care and that; care records and risk assessments lacked detail about people’s needs and the care they received and there was a lack of management oversight. As a result, we undertook a focused inspection to review the key questions of safe, effective, responsive and well-led only.

For the key question 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, effective, responsive 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 Ace Homecare London on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

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

We recommended that the service sought further advice and guidance from a reputable source around the assessment of people’s mental capacity to make particular decisions about their care and support, how peoples communication needs were met and how the service ensured that people were protected from potentially unsuitable care workers.

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.