Aegis Care

Aegis Care is a domiciliary care agency providing personal care to people in their own homes. 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. At the time of the inspection there were 5 people receiving the regulated activity personal care.

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

People said they felt safe using the service. There were enough staff to care for people safely and correct staff recruitment procedures were followed. Staff understood about safeguarding and how to report concerns. People’s care plans contained risk assessments, with information about how to keep them safe.

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.

There were systems in place to monitor the quality of service including staff supervisions/appraisals and satisfaction surveys. A quality assurance audit was undertaken, although we have made a recommendation about how this could be developed further.

Rating at last inspection

The last rating for this service was good (published December 2019).

Why we inspected

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

This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements. For those key questions not inspected (Effective, Caring and Responsive) we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating has remained as good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Aegis Care on our website at www.cqc.org.uk.

Enforcement and recommendations:

We have made a recommendation about the further development of quality assurance audits undertaken by the service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect. For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Aegis Care is a Domiciliary Care service which provides support to people, mainly with mental health difficulties, in their own homes. The head office is located in the Swinton area of Greater Manchester and support is provided to people who are aged 18 and above.

We last inspected Aegis Care in September 2015 and rated the service as Good, however the well-led key question was rated as Requires Improvement due to limited quality assurance systems being in place at that time to monitor the quality of service being provided to people. At this inspection, we found the service has improved in this area, although we have made a recommendation about how these could be expanded further.

At the time of the inspection there were approximately 130 people using the service, however only five were in receipt of a regulated activity which was personal care. As such we only focussed on people in receipt of a regulated activity during the inspection.

There was a registered manager in post. 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 this this inspection we found the service remained Good.

Why was the service rated as Good?

People told us they felt safe as result of the care and support they received and staff understood their responsibility with regards to safeguarding and how to report concerns.

Staff continued to be recruited safely, with appropriate checks undertaken before staff commenced employment. The people we spoke with told us staff always turned up on time, had never experienced any missed visits and that staff stayed for the correct length of time for each call.

People had individual risk assessments in their care plans and the service maintained and log of any accidents and incidents which had occurred, which detailed any follow up actions taken.

At the time of our visit, the service did not currently take the responsibility for administering medication for people who used the service and as such, we have not covered this area as part of our inspection.

Staff told us they received enough training and said they felt well supported to undertake their roles. Although there was a training matrix in place, it indicated that some courses were due for renewal and were out of date. The manager told us these would be undertaken following the inspection and the training matrix updated accordingly. We have made a recommendation about this in the detailed findings of the report.

Staff received regular supervision as part of their ongoing development. Appraisals were being held, although as part of supervision sessions. We discussed with the manager about ensuring these sessions were kept separate so that staff were being given the opportunity to discuss their performance over the year.

People told us they received enough to eat and drink. The support people required was detailed in their care plans so that staff had relevant information to follow.

The people we spoke with told us they were happy with the care and support they received and described staff as kind and caring.

People were supported by staff to be independent where possible and be involved with tasks to keep up their skills. The service also took people’s equality, diversity and human rights needs into account when delivering care and support to ensure care was person centred.

Each person who used the service had a care plan in place, detailing the care and support they required. Although the registered manager told us the content was regularly reviewed, this was not always clearly documented. The service were in the process of updating care plans to a new format and we were told reviews would therefore be clearly recorded once they had been transferred. The care plans were also disorganised with no index system to clearly separate each individual section. There were also lots of old, historic documents about people which made people’s current care needs hard to find. The registered manager told us they would make the care plans more organised following the inspection.

We saw complaints were recorded and detailed any follow up actions required. A service user guide was also in place, informing people how they could express if they were unhappy with the service they received.

Since our last inspection, the registered manager had introduced additional governance systems to ensure the quality of service was being monitored effectively. This included audits of people’s care plans, risk assessments and daily notes. Spot checks/observations of staff had also been introduced so that supervisors could ensure staff were working to high standards.

We looked at how people who used the service provided consent to their support and found that there were appropriate arrangements in place. One person said to us; 'I'm fully in agreement with my support package and for the reasoning behind it'.

We looked at four staff files to ensure that the provider had recruited staff safely and had conducted the appropriate checks on new staff prior to them commencing in their job role.

We found that Aegis Care had appropriate systems in place to monitor the quality of service provision and to handle complaints effectively, although we felt that recording of the audits and staff meetings could be improved.

We spoke with three people who used the service. One person told us 'They are very efficient, very friendly and nice with me. My family like them'. Another person said 'I am absolutely satisfied' and a third told us 'they are lovely, everyone is really nice'.

We saw that all relevant policies and procedures were in place. We saw that safeguarding people who used the service from the risk of abuse was taken seriously and followed up appropriately and that mental capacity was considered as a matter of course. We spoke with three staff members who all demonstrated an awareness of safeguarding issues and reporting procedures.

We observed that appropriate recruitment procedures were in place, supervision was given to staff on a regular basis and ongoing training and development was offered. We spoke with three staff members, all of whom felt very well supported by the company.

We saw that there was an appropriate complaints policy and complaints were dealt with efficiently. Systems were in place to allow the continual monitoring and improvement of the service delivery.