26 January 2016
During a routine inspection
Portsmouth, Apex Companions Limited, provides personal care services to people in their own homes. They provide services to older people and people living with dementia. At the time of our inspection there were 180 people receiving personal care from the service. There were 70 care staff, one senior co-ordinator and two co-ordinators who planned people’s care. There were three senior care staff, one deputy manager who was on maternity leave, one administrator and a registered manager.
A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People’s care visits were sometimes provided later than planned because travel time was not allocated. People felt safe and had regular care staff who met their needs. However, people may not always be receiving a safe service if certain aspects of their care were not provided at specific times, such as medicines, personal care and preparing meals.
People were not always supported to eat and drink at the times they requested and this could have an effect on their well-being.
The registered manager and staff demonstrated a good understanding of the Mental Capacity Act 2005 but did not always put this understanding into practice. We have made a recommendation for the provider to review the Mental Capacity Act 2005 and its subsequent codes of practice.
Feedback was sought and individually responded to. However the overall results were not analysed or evaluated to help improve service delivery. Audits were not completed or evaluated to help improve practice. Recording systems were duplicated and caused confusion on what was the most up to date information. Notifications had not been sent to the Commission for all four safeguarding concerns received by the service.
Staff received an induction programme and regular on-going training. Staff felt supported but did not always receive regular supervision in line with the provider’s policy. However, people and their relatives said they received care from regular staff and felt they were well matched with care staff and they had the skills and knowledge to carry out their roles effectively.
People were supported to maintain good health and access on-going healthcare support.
Risk assessments were completed of the environment and any manual handling equipment that would be used to support people with their care safely. Safe recruitment practices were followed.
People and their relatives were positive about the care and support received from care staff and the office staff. People were involved in their care and made decisions about their care. People’s independence, privacy and dignity was respected and promoted.
People’s needs were regularly assessed and reviewed. People’s care plans were personalised and individual, detailing how people like to receive their care. People were involved in their care planning and confirmed they had control over their care planning.
People and their relatives raised concerns with the service and felt these concerns were dealt with. People and their relatives we spoke to said they had never made a complaint but felt confident to raise one and that this would be dealt with. Complaints which had been received had been dealt with, responded to and actioned where required.
There was a registered manager and they demonstrated a good understanding of the service. There was a mixed response from people about the management and leadership of the service.
Staff felt supported by the registered manager. Staff were supported to question practice and were confident that concerns would be dealt with by management. Staff demonstrated an understanding of what to do if they felt their concerns were not listened to by management.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found a breach of the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of this report.