Background to this inspection
Updated
3 September 2019
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
The inspection was carried out by one inspector and one expert by experience (ExE). An ExE is a person who has personal experience of using or caring for someone who uses this type of care service, in this case older people, some of whom were living with dementia.
Service and service type
A1 Quality Home Care Limited is a Domiciliary Care Agency. The agency provides care and support for people in their own homes. The Care Quality Commission (CQC) regulates the care provided and this was looked at during the inspection.
The service has a manager registered with the CQC. 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 48 hours’ notice of the inspection visit because we needed to be sure that staff, people and relatives would be available to speak with us.
What we did before the inspection
The provider submitted a Provider Information Return (PIR) on 11 June 2019. Providers are required to send us key information about their service, what they do well, and improvements they plan to make. This information helps support our inspection.
Before the inspection we reviewed the information we held about the service. This included statutory notifications sent to us by the registered manager about events that had occurred at the service. A notification is information about important events which the provider is required to tell us about by law. We used this information to decide which areas to focus on during the inspection.
During the inspection
During the inspection we spoke to five members of staff, including the provider and registered manager. We spoke to 13 people, eight relatives and seven professionals. We looked at nine people’s care plans, audits and quality assurance reports. We looked at staff personnel files, complaints and compliments and Medicine Administration records (MAR).
After the inspection
After the inspection we continued to seek clarification from the provider to validate the evidence we found. We looked at survey results and spoke to three professionals who had regular dealings with the service. We also visited four people and their relatives in their own homes.
Updated
3 September 2019
About the service
A1 Quality Home Care Limited is a domiciliary care agency. The agency provides care, support and personal care to people living in their own homes. At the time of the inspection, care was being provided to 56 people. Most people were older and some were living with dementia. 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 told us that they felt safe when staff were in their homes. Assessments were carried out to identify risks and these were reviewed regularly. People, relatives and professionals were involved in the review process. People generally had regular staff looking after them and they got to know them well. The agency employed enough people to meet people’s needs and care calls had not been missed. Staff were recruited safely and had a good understanding of safeguarding and what procedures to follow if they had concerns. Some people were supported with medicines and staff were trained to do this.
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. Everyone told us that staff had a good understanding of their care and support needs. Some people received help with eating and drinking. Staff had completed food hygiene training. People were supported to make choices about their care and had access to health and social care professionals. Staff had regular supervision and spot checks to ensure continued good care and support for people.
People were treated with compassion, respect and dignity. Staff knew people well and knew about their care and support needs. People’s privacy was respected and their health and social wellbeing was promoted. A relative told us, ‘We feel supported by A1, they are brilliant.’
Staff knew how to communicate with people who had different needs. Staff had had dementia training and were able to tell us how they help people communicate and make choices about their support needs. A complaints policy was in place and a copy was placed in everyone’s homes. There was a robust system for dealing with complaints and incidents.
People, relatives, staff and professionals told us that the service was well run. A person told us, “Overall it’s very satisfactory, I’m happy with everything.” A relative said, “I do feel the care is to a good standard yes and I would say so if it felt otherwise.” A member of staff told us, “It’s well organised. I actually enjoy coming to work.” The service had established links within the local community.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 27 September 2018) and there was one breach of regulation. The provider completed an action plan after the last inspection. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating. We found no evidence during this inspection that people were at risk of harm.
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.