Absolute Care and Support (UK) Limited

Updated 18 January 2024

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

The inspection was carried out by 2 inspectors and 1 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.

This service also provides care to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care service.

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 a registered manager in post.

Notice of inspection

We gave a short period 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.

Inspection activity started on 11 December 2023 and ended on 18 December 2023. We visited the location’s office on 12 December 2023. We visited both of the extra care schemes on 15 December 2023.

What we did before 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. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 10 people who used the service and 7 relatives about their experience of the care provided. We spoke with 14 members of staff including the provider, registered manager, care co-ordinator, senior care workers and care workers.

We reviewed a range of records. This included multiple people’s care records and medication records. We looked at records in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

Updated 18 January 2024

About the service

Absolute Care and Support (UK) Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats. In April 2023, the service also acquired 2 extra care schemes called Birch Court (20 flats) and Portland House (40 flats) situated in the borough of Stockport. Extra care schemes operate in purpose-built properties, which provide accessible and safe housing for older people to live independently. At the time of the inspection, 18 people lived in Birch Court, 36 people lived in Portland House and 67 people used the domiciliary care 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.

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

People's medicines were not always safely managed. Medicine recording systems were not robust. The service was not following the provider’s medicine policy in relation to ‘as required’ medicines. Although staff received training in administering medicines, they did not always receive a medicine competency assessment [an observation to assess staff competency in administering medicines]. People were protected from the risks of abuse and staff were trusted to keep them safe.

Auditing systems were not always robust and auditing processes had not picked up on the discrepancies we found during this inspection. In both of the extra care schemes, there was a lack of governance, leadership and auditing systems.

The provider had systems in place to monitor staffing levels. An electronic system was used to determine staffing levels, issue staff rotas and deploy staff to people’s care visits. However, staff rotas showed travel time was not always allocated between calls. We received mixed feedback from people about them receiving regular staff for their care visits.

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; however, the systems in the service did not always support this practice. There was limited information about people's cognition and mental capacity in their care plans and the provider had no specific mental capacity assessments in place. We have made a recommendation about the provider reviewing their systems in place to work within the principles of the Mental Capacity Act (MCA).

Staff had received an induction when they first started working at the service and mandatory training relevant to their roles had been provided. However, there was a lack of training completed related to people's specific conditions. We have made a recommendation about the provider reviewing their training systems. People told us staff were on time for their visits, and if on occasions staff were delayed they were informed.

People's rights were promoted. People were treated with dignity and privacy. Staff had received training in equality and diversity, and they were committed to ensuring people were treated well. People’s views and decisions about care were incorporated when their care packages were devised. People’s independence was encouraged where possible.

People and their relatives told us they were involved in the care planning, which was reviewed regularly. People and their relatives told us the care provided met people’s needs. People’s communication needs were met. Care plans did not contain people’s end of life wishes. The registered manager assured us they will update people’s care plans to incorporate their end of life wishes for those who wanted to disclose them.

The culture was open and inclusive. Staff said they enjoyed their roles and liked the company they worked for.

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 26 March 2018).

Why we inspected

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

Enforcement and Recommendations

We have identified a breach in relation to good governance.

We have made recommendations about the provider reviewing their systems in place to work within the principles of the MCA and about the provider reviewing their training systems.

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.