Archived: Agincare Live-in Care Services

Updated 17 December 2014

We visited the office of the service on 9 and 14 July 2014 where we spoke with three staff who coordinate care and provide telephone support to people and staff, two senior staff, and the manager. We visited six people using the service in their homes with their permission on the 10 and 11 July 2014, and spoke with a further 20 people and eight relatives by telephone.  We also spoke with twelve staff who were providing care in people’s homes, and four assessors. The assessors assessed people’s needs, completed care planning documents, carried out staff supervision and monitored the quality of care. We also spoke with eight health and social care professionals.

The inspection team consisted of a lead inspector, one other inspector and an expert by experience, who had experience of older people’s care services. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.

We observed interactions between staff and people in people’s homes. We reviewed a range of records about people’s care and how the service was managed that included eleven people’s care records, six staff files that included their supervision and recruitment records, the complaints folder, and a selection of quality assurance audits that the service had completed.

Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. Before our inspection, we reviewed the information included in the PIR along with information we held about the service and notifications they had sent us since their last inspection. A notification is information about important events which the service is required to send us by law.

We last inspected this service in October 2013 and found them to be compliant with the regulations we inspected.

This report was written during the testing phase of our new approach to regulating adult social care services. After this testing phase, inspection of consent to care and treatment, restraint, and practice under the Mental Capacity Act 2005 (MCA) was moved from the key question ‘Is the service safe?’ to ‘Is the service effective?’

The ratings for this location were awarded in October 2014. They can be directly compared with any other service we have rated since then, including in relation to consent, restraint, and the MCA under the ‘Effective’ section. Our written findings in relation to these topics, however, can be read in the ‘Is the service safe’ sections of this report.

Updated 17 December 2014

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 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

The inspection was announced 48 hours before we visited.

Agincare Live In Care Services provides care to people in their own homes. They provide live in care staff to support people with personal care needs throughout England. At the time of our inspection there were 170 packages of care being provided to people in their own homes. This number changes weekly. The provider is registered to provide personal care.

At the time of our inspection there had been no registered manager in post since July 2013. The current manager had been managing the service since January 2014. They had submitted an application to become the registered manager in April 2014. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People’s experience of their care was mixed. While most people and their relatives were very happy, others were not. Most people’s concerns related to times when their regular, or permanent, staff member was on a break.

People’s safety was being compromised in a number of areas. This included how they were protected from the risks of abuse and how possible abuses were identified and responded to. The provider had not notified the Commission about some allegations of abuse in a timely fashion.  

Medicines were also not managed in an appropriate way. There were gaps in records and some records did not accurately reflect the medicines that staff were giving people.

Staff were not always following the Mental Capacity Act 2005 for people who lacked capacity to make a decision. The staff responsible for assessing people’s ability to consent had not received training in the Mental Capacity Act 2005 and were not able to describe how capacity should be assessed.

We found that people’s care needs were assessed, but their care was not always delivered consistently. In some cases, this either put people at risk or meant they were not having their individual care needs met. For example one person wasn’t able to go out for three weeks because the staff weren’t confident to support them with their mobility. Sometimes risks to people’s welfare were not identified as part of their care plan. 

Staff were not always trained and supported to provide the care people needed. We found that staff had received induction training but staff did not always get the specialised training they needed around people’s particular needs. This meant they were not always able to provide appropriate care. We found examples of this when people had specialist health care needs and also in end of life care.

Systems in place to monitor the quality of the service were not effective. Staff who undertook assessments, quality monitoring and staff support in the community did not have adequate training to undertake this role effectively and safely.     

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.