Background to this inspection
Updated
12 February 2020
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
This inspection was carried out by one inspector and two Experts 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. The Experts by Experience made telephone calls to people and their relatives.
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
We gave the service 48 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.
Inspection activity started on 27 January 2020 and ended on 30 January 2020. We spoke to people and relatives on 27 January 2020. We visited the office location on 28 January 2020 and we spoke to care staff on the 29 and 30 January 2020.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We also spoke with six people and 18 relatives about their experience of the care they received. We used all of this information to plan our inspection.
During the inspection
We spoke with the registered manager who is also the nominated individual for the provider. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with the finance manager and two field care supervisors.
We reviewed a range of records. This included 13 people’s care records and seven people’s medication records. We looked at eight staff files in relation to recruitment and staff supervision. We also reviewed records relating to the management of the service, including quality assurance records.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We also spoke with eight care staff.
Updated
12 February 2020
About the service
Astor Care and Nursing Agency is a domiciliary care agency providing personal care to people living in their own homes. At the time of the inspection the service was supporting 187 people with personal care and support.
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 and relatives of people using the service spoke positively of the service and the care and support that they received. They told us that they were supported by a regular team of care staff with whom they had developed caring and respectful relationships with.
People told us that they felt safe and confident living at home independently with the care and support that they received from care staff. Staff knew the signs to look for if abuse was suspected and told us of the actions they would take to protect people from abuse.
Care plans detailed people’s identified risks associated with their health and care needs with clear guidance to staff on how to manage those risks to keep people safe.
Safe medicines management and administration processes in place ensured people received their medicines as prescribed and on time.
People and relatives confirmed that they were always supported by staff that they knew who arrived on time and always stayed their full allotted time. Recruitment processes followed ensured that only those staff assessed as safe to work with vulnerable adults were employed.
People were supported by care staff who had been appropriately trained and skilled in their role. Care staff told us they were regularly supported through supervision and annual appraisals.
People were supported to eat and drink enough where this was an assessed need. The service supported people to lead healthy lives and supported them to access relevant health care services where required.
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.
Care plans were person centred and detailed, giving care staff the appropriate information and guidance to support people with their needs and wishes.
People and relatives knew who to speak with if they had any complaints and were confident their concerns would be dealt with appropriately and in a timely manner.
Management oversight processes in place enabled the service to monitor the quality of care people received. Where issues were identified these were addressed immediately with further learning and development implemented to improve people’s experiences.
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 14 February 2017).
Why we inspected
This was a planned inspection based on the previous rating.
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.