Action 2 Care

Action 2 Care is a domiciliary care and supported living service that provides personal care and support to people living in their own home and included 24 hour care. The supported living services did not include communal facilities. At the time of our inspection there were 4 people using the service.

Not everyone who used the service received personal care. 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.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

People’s experience of using this service and what we found

Right Support:

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.

People were supported by staff to make decisions about their day to day life. This included enabling people to live in their own home with support or within supported living accommodation.

Staff supported people to achieve their goals to maintain and achieve greater independence, which included the completion of household tasks such as cleaning, grocery shopping, food preparation and cooking.

People were supported to make decisions as to how they spent their day, which included voluntary work and the pursuit of leisure activities within their local community. People were supported to maintain and develop new relationships with their peers.

Staff had a good understanding of people’s needs and how to respond and support people to maximise their wellbeing when they became anxious or distressed.

Right Care:

Some improvements were needed to electronic care records for medicine management to ensure it was clear which medicine people had taken. People were supported to access health care services where required. Staff followed guidance developed by health care professionals to support and maintain people’s health and wellbeing.

People’s needs were assessed and kept under review. Assessments considered all aspects of people’s care, considering their human rights and lifestyle choices.

People’s support plans were personalised and provided information as to how they wanted staff to support them. People and relatives were positive about the support and care provided and the impact of positive staff support on gaining confidence and independence.

People were supported by staff who were inducted into their role and had undertaken the necessary training to enable them to meet people’s needs.

Right Culture:

The registered manager had a clear vision as to the service they wished to provide. Systems and processes were in place to assess the quality of the service being provided, which included a range of audits. People’s views as to the quality of the service were sought and analysed. The registered manager had developed action plans to bring about improvement based on the outcome of audits and people’s views.

People had access to information in a format to support their understanding and information about their communication style, communication needs were recorded within their support plans.

Staff spoke positively of the support they received from the registered manager, which included regular meetings and supervision. Communication systems amongst all staff were effective to promote good quality care and support.

Rating at last inspection

The last rating for this service was requires improvement (published 15 February 2022).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Not everyone who used the service received personal care. 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.

Care plans reflected people's individual needs and preferences.

People and relatives were generally satisfied with the care that staff provided and with the management of the agency. They said safe care was provided and protected people against abuse, neglect and discrimination.

Enough staff were employed to meet people’s needs and timely calls were in place to provide personal care.

The registered manager understood their responsibilities and worked in an open and transparent way. People and relatives were aware of how to approach the registered manager to raise concerns or complaints. They and staff were positive about the registered manager and said their views were always listened to and taken into account.

Details of how to reduce risks to people's safety were not always included in people’s care plans.

Recruitment practices were not fully in place to ensure only suitable staff worked at the service.

Quality assurance systems were not fully in place to ensure people were provided with a quality service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements. No areas of concern were identified in the other key questions. We therefore did not inspect them.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Action 2 Care on our website at www.cqc.org.uk.

At our last inspection there were two continued breaches in Regulations 12 (Safe Care and Treatment) and 17 (Good Governance). At this inspection we found enough improvement had been made and they were no longer in breach of Regulations. However, we have found evidence that the provider needs to make improvements. Please see the Safe and Well-led key question.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Action 2 Care is a domiciliary and supported living provider registered to provide personal care to children, younger adults and older people with a physical disability, sensory impairment, learning disability or autistic spectrum disorder, mental health needs and dementia.

Not everyone who used the service received personal care. 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. Six People were receiving personal care at the time of our inspection.

People’s experience of using this service and what we found

The recording of medicines was not always undertaken in line with the providers policy, this put people at risk of receiving their medicines incorrectly. However, people told us they received their medicines on time and that staff were confident with their medicines. Staff had a good knowledge of infection control and had access to gloves and aprons. Risk assessments did not always fully reflect people’s needs or take account of all risks to their health and wellbeing. People were supported by staff that knew how to recognise abuse and report concerns. The service did not seek a full employment history from applicants or keep interview records. We have made a recommendation about this.

There were no quality assurance systems and processes in place to enable the provider to assess, monitor and improve the quality and safety of the service. Staff felt valued by the management team and their colleagues. People’s feedback on their care was sought and they told us they would recommend the service.

Staff had received training relevant to their role in their previous employment. This was not refreshed when they joined Action 2 Care. Staff received regular supervisions and felt supported in their role. People were supported to eat and drink enough and to access healthcare as needed. 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.

People received support from a small and consistent team of care staff. People and staff had developed caring relationships together and enjoyed each other’s company. Staff told us they cared for people as if they were their own relatives. People’s privacy and dignity was respected, and their independence promoted.

Systems and processes were in place for the management of complaints. There had been no complaints. People and their relatives knew how to complain and felt confident any concerns would be addressed to their satisfaction. People received care from staff that knew their hobbies and interests and care was personalised. End of life care plans were not in place. We have made a recommendation about end of life care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 05 July 2018, and this is the first inspection.

Why we inspected

This was a planned inspection.

Enforcement

We have identified breaches in relation to Regulation 17 (2) (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and Regulation 12 (2) (g) (Safe Care and Treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

For requirement actions of enforcement which we are able to publish at the time of the report being published. 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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.