Archived: Aims Homecare Limited

Updated 14 September 2018

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 14 August 2018 and was announced. We gave the service four days’ notice of the inspection visit because the location provides a domiciliary care service and we needed to be sure that they would be in. The inspection was undertaken by one 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.

Before the inspection we reviewed the information we held about the service, including statutory notifications submitted about key events that occurred at the service. We also reviewed the action plan provided following our last inspection.

At the office visit we spoke with the registered manager and the care coordinator. We reviewed seven people’s care records and three staff records. We also viewed records relating to the management of the service, spot checks, rotas and call logs. After the visit to the office we made telephone calls and spoke with five staff, 11 people and seven relatives. We received email feedback from a representative from the local authority. We asked the registered manager to send us some information via email after the inspection and this was received.

Updated 14 September 2018

Aims Homecare Limited delivers personal care to people in their own homes. At the time of inspection they were supporting 73 people. This included a variety of calls from 30 minutes to full 24 hour live in care.

At our last inspection we rated the service ‘good’ overall. At this inspection we found the evidence continued to support the rating of ‘good’ and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At our last inspection we rated the service ‘requires improvement’ for the key question ‘well-led’ and found them in breach of regulation relating to good governance. Following our inspection the registered manager submitted an action plan stating what action they would be taking to address the concerns identified. At this inspection we found that action had been taken, the service was no longer in breach of regulation and the rating for the key question ‘well-led’ had improved to ‘good’. However, we found the rating for the key question ‘responsive’ had deteriorated to ‘requires improvement’.

People felt safe receiving care from Aims Homecare. Staff were aware of their responsibility to safeguard adults from avoidable harm and were knowledgeable on safeguarding adults’ procedures. Risks to people’s safety were assessed and appropriate procedures were in place to manage and mitigate those risks. There were sufficient staff to meet people’s needs, however, at times people received late visits. The registered manager was aware of this and the scheduling of appointments was being reviewed to reduce travel time between calls and improve punctuality. Safe recruitment practices were adhered to. People received support with their medicines and infection control procedures were adhered to.

People received support from staff who received regular training and had the knowledge and skills to undertake their duties. Staff were aware of people’s dietary requirements and provided any support required with meals and access to drinks. Care staff were knowledgeable about people’s medical needs and liaised with health care professionals to obtain specialist advice about how to support the person. Staff escalated any concerns about a person’s health to the relevant healthcare professional. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People and relatives were complimentary about the staff. They said they had established trusting positive relationships with their usual staff member, however, the recent changes in staff allocation had impacted on the quality of these relationships. Staff were required to undertake all of their training in English to ensure their verbal and written English was up to a certain standard and ensure they could communicate with people in a way the person understood. People and their relatives were involved in decisions about the care and support they received. Information was gathered about people’s life histories and what was important to them which informed the support provided and aided conversations. Staff respected people’s privacy and dignity.

People received support with their care needs. On the whole people were complimentary about how they were supported. However, due to scheduling difficulties we heard that people had experienced a number of changes in their allocated staff member and this impacted on the quality of care they received. They felt the newly allocated staff member did not have as much knowledge about their care needs and how they liked to be supported. On the whole care records provided information about people’s needs and how they wished to be supported. However, at the time of inspection specific information was not collected about people’s end of life wishes. A complaints process was in place and we saw trends from complaints was discussed with the care staff. However, we received mixed feedback from people and relatives about how they felt their complaint was handled and responded to.

The registered manager had taken the necessary action to address the previous breach of regulation. There were processes in place to review the quality of care records. Care records had been reviewed and additional improvements were being made to incorporate feedback following a CQC inspection at the provider’s other service. There were systems in place to track staff’s compliance with training requirements and we saw regular programmes or spot checks and supervision. Action was taken to address any performance concerns identified through spot checks with the individual staff members. There were systems in place to obtain feedback from people, their relatives and relevant health and social care professionals. The provider had developed a business development plan for 2018. This looked at how they could increase recruitment, stabilise staff turnover and improve efficiencies including reducing travel time for staff. The care coordinator was in the process of amending some staff allocations to make these efficiencies which was impacting on the consistency of staff allocation currently, but would help to establish this consistency in the future. The registered manager adhered to their CQC registration requirements.

Further information is in the detailed findings below