We carried out a review of the data available to us about Albury Care Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Albury Care Limited, you can give feedback on this service.
Albury Care Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults, younger disabled adults and children.
At the time of the inspection, 62 people were using the service.
The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in.
This was a comprehensive inspection to see what improvements the provider had made to ensure they met regulatory requirements.
At our last comprehensive inspection on 8 November 2016, the service was in breach of two regulations related to quality monitoring and staff training. We rated the service as requiring improvement. We had found that care records lacked detail and were not reviewed regularly. In addition, monitoring systems to manage complaints, incidents and accidents were ineffective. We also found that staff had not completed the provider's mandatory training and refresher courses.
At this inspection, we found improvements made ensured people received effective care. Care plans showed sufficient detail about people’s needs and the support they required. The quality of care underwent checks and monitoring to identify and resolve concerns about people’s safety.
There was a registered manager in post. A registered manager is a person who has registered with the CQC 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 had an assessment of their needs and preferences about care delivery. Staff were aware of risks to people’s health and safety and knew how to support them safely. People received the support they required with their nutrition and hydration and to maintain their health. Enough suitably recruited staff were deployed to meet people’s needs. Staff administered and managed people’s medicines in line with the provider’s procedures. Staff knew how to prevent and control the risk of infection.
Staff provided care in line with best practice guidance and the requirements of the Mental Capacity Act 2005 (MCA). People received care from staff who received an induction, training and supervision to enable them to deliver care effectively.
People received care that met their individual needs in line with their preferences. Staff treated people with respect and maintained their dignity and privacy.
People using the service and their relatives knew how to raise concerns and make a complaint about care delivery if they needed to.
People enjoyed a person centred approach to their care and support. Staff were supported in their roles and had access to guidance from the registered manager and the management team.
An open and honest culture existed at the service about care delivery. The quality of the service underwent regular monitoring to improve the care and support provided to people. The registered manager worked closely with other agencies to provide effective care.
Albury Care Limited provides domiciliary and live in care to people in the community. At the time of our inspection 12 people were receiving 24 hour live in care and support with their personal care. In addition, 12 people were receiving a domiciliary care service. Of the 12 people receiving a domiciliary care services, four people were supported with their personal care.
A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. At the time of our inspection the service did not have a registered manager. The current manager had been in post since August 2016 and had applied to be the registered manager. The CQC registration team were undertaking a fit persons’ interview two days after our inspection to formally assess their suitability.
At our previous inspection on 4 December 2013 the service was in breach of the Health and Social Care Act 2008 (regulated activities) 2010 regulation relating to care records. At this inspection we found that whilst improvements had been made there were still areas requiring improvement. Some care records still lacked detail and were not regularly reviewed to ensure they were accurate and up to date.
In addition the provider did not have robust procedures in place to review key performance information to identify trends and areas requiring improvement in regards to complaints, incidents and accidents. A formal process was not in place to spot check staff’s performance and check on the quality of care delivery.
At our previous inspection we identified the provider’s training records was not kept up to date. At this inspection the training records had been updated but showed that staff were not up to date with their training requirements and had not completed the provider’s mandatory refresher courses.
The provider was in breach of the legal requirements relating to staffing and good governance. You can see what action we have asked the provider to take at the back of this report.
Improvements had been to made to review risks to people’s safety and ensure appropriate management plans were in place. Staff supported people to manage and mitigate the risks to their safety and welfare.
Staff had updated records relating to medicines management. We saw that accurate medicines administration records were maintained and people confirmed they received the support they required to ensure they received their medicines.
There were sufficient staff to meet people’s needs. The manager arranged the staff rota to ensure people received support from the same care staff to enable consistency in service delivery. The manager matched staff and people to ensure they were comfortable with each other and were able to build a good rapport.
Staff provided people with the support they required. This included their personal care as well as with nutritional and healthcare needs. Staff liaised with people’s relatives and the other healthcare professionals involved in their care if they had concerns about a person’s health.
Staff involved people in decisions about their care and undertook care in line with people’s preferences. Staff adhered to the Mental Capacity Act’s 2005 code of practice and people consented to care delivery. Where people were unable to consent to their care the manager involved legally nominated persons to make best interests’ decisions on the person’s behalf.
There were processes in place to obtain feedback from people and their relatives. The manager had recently sent satisfaction questionnaires to people to obtain their views and opinions on service delivery. There was a process in place to investigate and respond to complaints. Some people were unsure of the formal complaints process but felt comfortable speaking with staff if they had any concerns.
There was a new management team in place providing leadership at the service. Staff felt comfortable speaking with and approaching the new manager for advice or if they had any concerns. The manager was recently in post and was in the process of making improvements to service delivery. They were aware of the legal requirements and were in the process of making the necessary changes to meet those.
Some people's records did not include important information and others were completed inaccurately. We found that when a person's medication or their treatment was changed this information was not recorded appropriately in their records. This meant their risk assessments were not updated and the manager was not informed of these changes in line with the provider's policy.
We found people had been involved in the planning and delivery of their care by contributing to their care plans and being asked their preferences, likes and dislikes. The service had ensured people's safety and welfare by completing risk assessments and reviewing these on a regular basis.
The service had an appropriate recruitment process in place and had followed this when recruiting staff. Staff had been provided with appropriate training and support to work effectively and the service had taken steps to obtain people's feedback and act upon it to improve the service.
People who used the service told us that they made choices every day, and that their carers encouraged them to make choices. We were told that staff always attended to their personal care needs in private, and that the staff respected their privacy and dignity. They told us that they could not remember if they had a care plan. They told us that they were asked lots of questions about themselves. We were told that staff always listened to them, and they would do anything they asked of them. They stated that staff were very nice and helpful.