Angy Care Limited

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• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We identified 3 breaches of the legal regulations in relation to safe care and treatment, safeguarding and fit and proper persons employed. The registered manager would not engage with us throughout the assessment. The registered manager had not ensured the service was safe: Safeguarding was not well managed to ensure people were protected from the risk of harm and abuse. People’s health risks were not well managed or mitigated. There was a lack of information regarding people and their health risks which left people at a significant risk of harm. Incident and accidents were not well managed, there were no systems in place to ensure appropriate action could be taken if needed. Staffing and recruitment processes were not robust, there was no information around people’s visits. People’s medicines were not well managed: there was a lack of processes and a failure to provide guidance to guide staff.

This service scored 38 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

While the people we spoke to expressed that they were generally happy with their care, our assessment found care did not meet the expected standards. For example, the registered manager failed to provide evidence that effective and robust systems were in place to manage incidents and accidents.

We could not collect evidence under this category from the registered manager as they did not engage with us throughout the assessment. The business manager told us they did not ‘deal with any incidents or accidents, that is the registered managers role’. We asked the business manager what happens if there is an incident when the registered manager is unavailable and they told us: ‘This doesn’t happen, but I guess the staff would text them (registered manager)’. We could not be assured that the registered manager and staff understood their roles regarding incidents and accidents.

We could not collect evidence under this category from the registered manager as they would not engage with us throughout the assessment. The registered manager failed to provide evidence that an effective system was in place to review and analyse incidents and accidents to ensure any actions or learning could be identified. We could not be assured that any incidents that had occurred had been actioned appropriately or that an effective system was in place should an incident occur.

We could not collect evidence under this category from the registered manager as they would not engage with us throughout the assessment. The business manager could not tell us any information about people’s pathways. They were unable to tell us when people started being supported by Angy Care. We could not be assured that the registered manager and staff were prioritising safety and continuity of care throughout people’s care journey.

While the people we spoke to expressed that they were generally happy with their care, our assessment found care did not meet the expected standards. For example, processes were not in place to ensure people received care that used a joined-up approach and considered the potential risks to people across their care journey. We were unable to gather feedback from partners as there was no one funded by a local authority.

We could not collect evidence under this category from the registered manager as they would not engage with us throughout the assessment. The registered manager failed to provide evidence that they had an awareness of risks to people across their care journeys and that care and support was planned and organised with people and relevant friends, family, advocates or other professionals. The registered manager also failed to evidence that processes were in place to ensure new care packages were fully assessed and referrals were made where relevant. One person’s care plan failed to detail if they had any other support from other professionals and how they could collaborate to ensure the person received a safe joined up approach to their care. We could not be assured people received continuity of care or that safe systems of care were in place.

While the people we spoke to expressed that they were generally happy with their care, our assessment found care did not meet the expected standards. For example, safeguarding systems and processes were not in place.

We could not collect evidence under this category from the registered manager as they would not engage with us throughout the assessment. Staff failed to provide evidence and assure us that they understood how to safeguard people and that effective systems were in place. We asked the business manager how they safeguarded people and what they did if there was a safeguarding concern. The business manager told us there ‘isn’t any safeguarding incidents’ and if there was, it would have to wait until the registered manager is back as they cannot access the systems. This meant immediate action could not be taken to keep people safe from abuse, neglect or harm. We could not be assured that safeguarding processes were in place or that people would be protected from the risk of harm or abuse.

We could not collect evidence under this category from the registered manager as they would not engage with us throughout the assessment. The registered manager failed to provide evidence that effective processes were in place to ensure people were safeguarded from the risk of harm or abuse. The registered manager had left the business manager in charge of the service while they were absent, however the business manager was unable to access any information relating to safeguarding processes. We could not be assured that safeguarding processes were in place or that people would be protected from the risk of harm or abuse.

While the people we spoke to expressed that they were generally happy with their care, our assessment found care did not meet the expected standards. For example, people’s health risks were not well managed.

We could not collect evidence under this category from the registered manager as they would not engage with us throughout the assessment. We asked the business manager if they knew what health risks a person needed support with. They told us they have a ‘mental health condition’ and thought it might be a dementia of some sort as they are forgetful. They were unable to provide us with any further information regarding the person’s mental health condition. One staff member told us they did not support with ‘that kind of thing’ (referring to personal care) and only supported the person to go out. Another staff member would not engage with us to assure us they understood how to support and manage people’s health risks.

The registered manager failed to ensure that risks to people’s health and well-being were well managed and mitigated, which left people at risk of harm. One person’s care plan was brief, non-specific and did not contain information around how to manage and mitigate people’s health risks. One person’s care plan detailed they had diabetes but contained no information as to how this was managed, what risks this posed to the person or guidance for staff on how they should support this person. The lack of information around the person’s diabetes left them at serious risk of harm. One person needed support with continence aids, however the care plan did not contain information on how to support the person manage that risk. There was no information or guidance in place for staff to follow to ensure they could support the person safely. One person’s care plan outlined they had a ‘mental health condition’. The care plan did not contain any other information as to what the condition was, how they managed it or what support they needed from staff. There was no guidance in place for staff to follow to ensure they could support the person safely. We could not be assured that people were being supported with their health risks, which left them at a significant risk of harm.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

While the people we spoke to expressed that they were generally happy with their care, our assessment found care did not meet the expected standards. For example, robust recruitment processes were not in place, appropriate training was not available for staff and information regarding people’s care calls was not in place.

We could not collect evidence under this category from the registered manager as they would not engage with us throughout the assessment. The business manager was able to show us recruitment files which were held within the recruitment part of the business that they had access to. The business manager told us they did not have access to any rotas or call data. They could not tell us what days people had their calls, what time or how long the duration of the call should last. We had no information about the calls and therefore could not be assured that these calls were taking place or that they were in line with people’s preferences.

We could not collect evidence under this category from the registered manager as they would not engage with us throughout the assessment. Robust and safe recruitment processes were not in place. The business manager showed us recruitment files. We reviewed one recruitment file which did not contain a full work history. Staff had not received training appropriate and relevant to their role. We were not able to review an overview of the training the service provided to staff, however recruitment files showed staff had not received training in diabetes management. We were not assured that rotas were in place, so staff knew information about their visits, including what day, time and the duration of the visit. We were not assured that supervisions or appraisals were taking place. This meant staff did not have the opportunity the develop and ensure they had the support they needed to deliver safe care.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

While the people we spoke to expressed that they were generally happy with their care, our assessment found care did not meet the expected standards. For example, there was no guidance for staff on how to support people with their medicines, including what level of support was needed.

We could not collect evidence under this category from the registered manager as they would not engage with us throughout the assessment. The business manager did not have any knowledge about the medicines management at the service. We were not assured that people’s medicines were being managed by staff who understood how to support people with their medicines.

We could not collect evidence under this category from the registered manager as they would not engage with us throughout the assessment. One person’s care plan detailed staff needed to ‘verify medication intake and assist with monitoring blood sugar levels’. There was no other information within the care plan to describe how staff would complete this. There was no medicine administration records and there was no information about what medicines the person was prescribed. Their care plan detailed the equipment to use including a blood glucose monitoring device. There was no guidance for staff on how to use this device, when to use it or the risks associated to the person while staff used it. The care plan also stated that staff should ‘regularly check medication schedules and dosages’. There was no information to guide staff on how they should achieve this. We were not assured that staff were competent to administer medicines. We could not be assured that medicines were being well managed which put people at significant risk of harm.