Background to this inspection
Updated
29 June 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 between 30 April and 9 May 2018 and was announced. We gave the service 2 days’ notice of the first site visit on 30 April 2018 because we needed to be sure someone would be available in the office to assist us with the inspection and organise for us to visit some people in their homes. We visited two people on 30 April 2018. We made telephone calls to staff and people who used the service between the 1 and 4 May 2018 and returned for a second site visit to the office on 9 May 2018.
The inspection was conducted by an adult social care inspector and an assistant inspector. Telephone calls to people who used the service were also made by two additional adult social care inspectors.
We used information the provider sent us in the Provider Information Return (PIR) to plan the inspection. The PIR is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed other information we held about the service. This included statutory notifications that had been sent to us. We contacted two local authorities for their feedback about the provider.
We visited the provider’s office and spoke with the registered manager, deputy manager and two care co-ordinators. We looked at six people's care records, medication records, four staff recruitment and training files and a selection of records used to monitor the quality of the service. We spoke with 10 care staff in the office or over the telephone. We visited two people in their own homes and observed care staff interacting with them, and spoke with a further 15 people who used the service over the telephone. We spoke with six relatives of people who used the service.
Updated
29 June 2018
This inspection took place between 30 April and 9 May 2018 and was announced. The provider, AJ Community Care Limited, was re-registered with the Care Quality Commission in March 2017 following a change of company name. Therefore, this was the first rated inspection of the AJ Community Care service '4225 Park Approach – Rubicon Square', since its new registration.
The service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the Leeds, Castleford and Wakefield areas. At the time of our inspection 107 people were using the service.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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. The registered manager was also the nominated individual for the provider and a company director.
The provider had policies and procedures in place to guide staff in safeguarding vulnerable adults from abuse. Staff we spoke with understood the different types of abuse and were able to explain what they would do if they had any concerns.
We found that people’s needs were assessed and risk assessments were in place to reduce risks and prevent avoidable harm.
The provider had a robust system for the recruitment of staff. The provider had a system in place to ensure that care visits were scheduled in line with people’s requirements but we received mixed feedback about whether staff always arrived on time. Nobody we spoke with told us that any of their care visits had been missed.
Where staff supported people with their medicines, we found that this was recorded on medication administration records. Staff had received medication training and the provider completed audits of medication records to identify any gaps and anomalies. This enabled the provider to check that people were getting their medicines as prescribed.
Staff completed a range of appropriate training to help them carry out their roles effectively and there was a schedule for refreshing this training when it was required. Staff received regular supervision and appraisal.
The provider sought consent to provide care in line with legislation and guidance. There was information in care files about people’s mental capacity to make particular decisions and we found that care plans were signed by people who used the service where they had the capacity to do so. The provider did not always retain evidence where people had a lasting power of attorney with authority to make decisions in relation to their financial affairs or health and welfare. They agreed to do this moving forward.
People were supported to maintain good health and access healthcare services. We saw evidence in care files of contact with other healthcare services, such community nurses. People’s nutritional needs were assessed and support was provided with meal preparation and assisting people to eat and drink, where this was part of a person’s care plan.
People and relatives told us staff were caring. Some people spoke very affectionately about particular staff who cared for them regularly. People told us they were involved in decisions about their care and their choices were respected. Staff were able to explain how they provided support to maintain people’s privacy, dignity and independence.
Care plans contained information about people’s care needs, routines and preferences. There was also information about any needs relating to faith, culture, disability and communication. Care plans were updated at least annually or when people’s needs changed.
There was a complaints procedure in place. Records we viewed showed that complaints were investigated and responded to in line with the provider’s policy.
The provider had a quality assurance system in place, which included monitoring key performance information and care records, completing spot checks of care delivery and conducting satisfaction surveys. The provider worked in partnership with other organisations. There was a positive culture within the organisation and a focus on staff development and continual improvement.