Background to this inspection
Updated
6 January 2023
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
Two inspectors carried out this inspection.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was not a registered manager in post. A new manager had been in post for one month and had submitted an application to register. We are currently assessing this application.
Notice of inspection
This inspection was unannounced.
Inspection activity started on 8 November 2022 and ended on 23 November 2022. We visited the location’s office on 8 November 2022 and 16 November 2022. We visited people who used the service on 16 November 2022.
What we did before the inspection
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. 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 used all this information to plan our inspection.
During the inspection
We spoke with 4 people who used the service and 3 relatives about their experience of the care provided. We spoke with 9 members of staff including the manager, the quality assurance manager, 6 support workers and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included 5 people’s care records, 3 staff recruitment files and multiple medication records. A variety of documents relating to the management of the service, including policies, training records, maintenance records and quality assurance documents were reviewed.
Updated
6 January 2023
About the service
Aapna House is a domiciliary care agency providing personal care to people in their own homes. At the time of our inspection there were 35 people were using the service and receiving personal care. 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
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.
At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.
Risks to people were not always robustly managed. There was limited written information for staff around some key risks to people. People’s care plans were not always up to date, and were not always clear and consistent. Systems and procedures were not in place to ensure people’s medicines were accurately recorded, and clear guidance was not always in place for staff around people’s medicines. Safe recruitment procedures were not in place.
The management team did not have effective oversight of the service. Audits had not identified all of the issues we found on inspection and systems were not in place to robustly analyse incidents and look for trends.
Some areas of people’s care plans contained clear guidance for staff, and the provider completed environmental risk assessments to help keep staff and people safe. There were enough staff to support people and staff had received appropriate training. People were kept safe from the risk of abuse. The provider managed infection prevention and control safely.
There was a positive atmosphere amongst staff, people and relatives. People were happy with the care provided and relatives spoke about the positive impact the service had. Staff enjoyed their jobs and felt supported by management. Relatives and people told us communication was good, and people were supported to access healthcare and other professionals.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
Rating at last inspection
The last rating for this service was good (published 6 February 2020).
Why we inspected
The inspection was prompted in part due to concerns received about the quality of the service and organisational oversight. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions 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.
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 Aapna House on our website at www.cqc.org.uk.
Enforcement
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 in relation to oversight, recruitment and record keeping.
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.