Together at Home Ltd T/A Visiting Angels

Updated 30 June 2021

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 Care Act 2014.

Inspection team

The inspection was carried out 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

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced.

We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

We reviewed information we held regarding the service. This included notifications the provider is required to send us by law. We used all this information to plan our inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

On the 13 May 2021 we visited the site office and met with the registered manager, operations manager and business manager. We reviewed a range of records. This included three people’s care record and their medicines records. We looked at part of a fourth person’s records. We reviewed three staff files in relation to recruitment, training and staff supervision. A variety of records relating to work undertaken with the local community, the management of the service including policies and procedures were also reviewed.

On the 18 May 2021 the Expert by Experience telephoned and attempted to speak with 14 people and/or their relatives who used the service. They were successful in speaking with four people and six relatives about their experience of the care provided.

After the inspection

We wrote to twelve staff and received responses from ten staff. We wrote to nine health and social care professionals and received responses from four of them. We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 30 June 2021

About the service

Together at Home Ltd T/A Visiting Angels is a domiciliary care agency providing personal care and support to people living in their own homes. They are registered to provide care to all adults including those who may be living with dementia and have disabilities.

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. At the time of our inspection they were offering personal care to 18 people, some of whom had live in care workers.

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

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 and their relatives spoke very positively about the service they received and described care workers as kind and respectful and the registered manager as very approachable, enthusiastic and efficient.

The provider invested in their care workers and recruited staff who they assessed as having the right aptitude to be good care workers. They carefully matched care workers with people so there was the best chance of a good working relationship. They had arranged small teams of staff who worked “around” each individual. This offered consistency and promoted a good working relationship between people and their relatives.

There were excellent lines of communication within the service. The provider had facilitated systems which allowed people, relatives, care workers and the management team to communicate both as a small team for each person and as a part of the larger service.

Care plans were written in a personalised manner with the full involvement of people and their relatives. The registered manager contacted people and their relatives each week to ask if they were satisfied with the service they received. They were responsive in reviewing and adapting care plans according to people’s changing support needs and preferences.

They worked closely with community health professionals and were proactive in eliciting medical advice and support. They contacted health professionals to establish good working relationships and facilitated visits from physiotherapists who they felt would improve people’s mobility and independence and make a difference to the quality of their lives. Care workers were keen to learn new ways to support people to mobilise and encouraged exercise in line with physiotherapist recommendations.

The registered manager completed assessments to identify risks to people and provided guidance for staff so they could mitigate the risk of harm. People and relatives told us they felt safe with the care provided. The provider had systems to identify and report possible abuse. The care workers had received safeguarding adults training and demonstrated they could recognise signs of abuse and knew what action they must take.

Medicines were administered in a safe manner by staff who had received training to do so.

The provider had systems and procedures to monitor, check and audit care provided to ensure they provided a high level of personalised support. They were open to input from people, relatives and their staff and were continuously reviewing what had worked well and what required improvement so they could provide a high -quality service.

The provider had worked closely with health and social care professionals and liaised with charities for both the benefit of those people to whom they provided a service and for people living in the local community. Throughout the pandemic they had provided a variety of voluntary services which had included shopping, collecting medicines and companionship. In addition, they had facilitated talks on a variety of topics which had included falls prevention and nutrition and hydration. They had utilised the knowledge from these talks for the benefit of people they offered a service to.

This service was registered with us on the 19 March 2020 and this was the first inspection.

Why we inspected

We undertook this comprehensive inspection because the provider had not been inspected since they had registered with CQC.

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.

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