Archived: Agincare UK Brighton

At the time of our inspection, a registered manager was not in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider. The manager in position was in the process of registering with the CQC.

We spoke with eight people who received care and two relatives. We also spoke with the Director of domiciliary care for Agincare UK, the manager, locality manager and five care workers.

Below is a summary of what we found. The summary describes what people who received care and the care workers told us, what we observed and the records we looked at. If you want to see the evidence supporting our summary please read the full report.

Is it safe?

At the last inspections in May 2013, February and June 2014, we found Agincare placed people at risk due to failings in recordings on medication administration records (MAR) charts. We found people's MAR charts had gaps on and we were therefore unable to tell if people had received their medication or not. We asked Agincare to make improvements.

During this inspection, we found significant improvements had been made. MAR charts were completed correctly with no gaps or omissions in recordings.

Care workers told us they felt confident in medication administration and could approach office staff with any concerns or queries. People we spoke with confirmed they received their medication on time.

At the time of our inspection, a registered manager was not in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider. A manager was in position that was in the process of registering with the CQC.

We spoke with ten people who used the service and two relatives. During the inspection, we spoke with the manager, locality manager, care co-ordinator, field care supervisor and three care workers.

Below is a summary of what we found. The summary describes what people who used the service and the staff told us, what we observed and the records we looked at. If you want to see the evidence supporting our summary please read the full report.

Is it safe?

People received care from staff who had the qualifications, skills and knowledge to provide safe and effective care.

The service was aware of the requirements of the Mental Capacity Act 2005. Staff had received training and the manager demonstrated a sound understanding.

Accidents and incidents were monitored and allowed for the management to identify any emerging patterns or trends.

People had their own care plans which detailed the care needed to maintain their safety at home.

People were at risk of medication errors. We found that people's MAR charts still had gaps on. We were therefore unable to tell if people had received their medication or not. We are asking the provider to take action to improve their administration and recording of medicines.

Is it effective?

At the last inspection in February 2014, we found the service was non-compliant with record keeping. This was because staff files were missing information and people's care plans were not signed by the person.

We found that the service was now compliant with record keeping. Care plans clearly reflected user involvement and were signed by the person or their representative. Staff files had the information required to meet Schedule 3 of the Health and Social Care Act (HSCA) 2008. Schedule 3 of the HSCA 2008 documented that staff files must have included copies of employee's criminal record check to confirm they were safe to work with vulnerable adults.

People had up to date care plans which recorded information that was important to them. These included information about their health and support needs, as well as a clear description of their interests and what they wanted from the service. People told us that they had been involved in the planning and reviews of their care.

Is it caring?

All of the people we spoke with were very positive about the care and support they received.

Staff we spoke with demonstrated kindness and compassion for the people they supported.

We found that care workers understood the importance of promoting people's privacy and dignity. One care worker told us, 'When I'm supporting someone with personal care, I make sure they are covered, check the water temperature with them and make sure the curtains are closed.'

Is it responsive?

People were given the opportunity to express their views on the service provided and had a care review each year or sooner if required.

Where's people's health and care needs increased, we saw that the service responded appropriately. We saw that the service completed urgent reviews and increased packages of care when required.

There was a complaints policy and procedure in place if people or their representatives were unhappy with the service provided. We could see that complaints were handled appropriately and in a timely manner.

Is it well led?

To enable people to receive a good quality service the organisation had a quality control department that undertook regular audits of the service to identify improvements and monitor action plans.

The service had a business continuity policy in place. This made sure that each service had a plan in place to deal with foreseeable emergencies. This would reduce the risk of people's care being affected in the event of an emergency such as snow.

During our inspection we spoke with two people who used the service, two relatives and six members of staff. These included the locality manager, acting manager, field care supervisor and three care workers.

Care plans were holistic and meaningful to the person. Before receiving care, Agincare undertook a pre-assessment and identified the level of care required. People we spoke with were happy with the care provided. One person told us, "I'm very happy with the service." Another person said us, 'The care workers are very good, caring and reliable."

Appropriate arrangements were not in place in relation to the recording of medicines, and the provider still had actions to take to improve the recordings of Medication Administration Charts (MAR).

We found the provider had an effective system to monitor the quality of service that people received. Satisfaction surveys were sent to people who used the service and staff. Audits were carried out and their data was analysed to identify how the service could improve. Relevant planned improvements were followed up in appropriate time frame. One person who used the service told us, 'They check regularly to make sure I am happy with everything. If I want something changed then it will be done, they do listen to me'.

We found that some of people's files were incomplete due to missed recordings and updates. This meant that not all files were fit for purpose and accurate.

Staff understood the importance of gaining consent and people's right to make choices. People who used the service told us they were listened to and their consent had been gained before they had been provided with care.

Records showed that people's care needs had been assessed. However their care needs were not regularly reassessed and not everyone had been asked their opinion about the quality of service they received.

People told us that they were happy with the standard of care and support they received from staff. One person described the care staff as, 'Wonderful'. Another person said, 'Most of them are first class'.

Not all care plans were up to date meaning that people's care needs could be overlooked. The recording of medication was not thorough and put people at risk.

The service did not have a thorough method to check and ensure that people had received

the care and support they required. We were subsequently told by the provider that there was a system in place but that this was not being implemented.

People were supported to raise concerns or complaints and there was a procedure to deal with their complaint.