This service is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older adults.
At the time of inspection, there were 84 people receiving personal care services from the provider. Not everyone who used Apex Prime Shirley received support in the form of a regulated activity CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
The service was rated Requires Improvement at its last inspection in April 2017 and had breached one registration regulation regarding submitting notifications of serious incidents that occurred. Following the last inspection, we asked the provider to complete an action plan to show what they would do to meet the breach and improve the key questions of Well-Led to at least Good. At this inspection, we found that the provider had made improvements needed to meet the requirements of this regulation. The registered manager had a sound knowledge of their responsibilities of notifying CQC about significant incidents and had made these notifications in good time.
There was a registered manager in place. 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 told us that the registered manager had made improvements to the service since starting their role. These included improving consistency of staffing, improvement reliability of service in providing care calls and also improving communication between the provider and people.
The registered manager had made improvements to the system of auditing people’s care documentation. They had implemented training and a new system which was more robust in picking up errors or omissions.. The registered manager held regular staff meetings where feedback from people, complaints or issues about the quality of care were discussed and reviewed.
The registered manager had reduced instances where there were missed calls. All instances of missed calls were investigated to reduce the likelihood of reoccurrence. The provider had recently implemented an electronic call monitoring system which would alert the provider if staff did not arrive at their care calls at the agreed time.
Some people told us they did not receive a rota detailing the time of their care calls. The provider told us this facility was available to people upon request and the registered manager would ensure this service was offered to people and regularly reviewed. However, people told us they had consistent care teams who arrived at consistent times and therefore the impact of not receiving a schedule of visits was minimal.
During the inspection, the provider made the arrangements to ensure that the service’s previous inspection rating was clearly displayed on their website. This meant that by the end of the first day of inspection the provider was meeting the requirements of the regulation to display their rating in the office and on their website.
The registered manager had plans in place to ensure that people’s care needs were met in the event of an emergency. They had put plans and risk assessments in place to help ensure that the most vulnerable people had their care prioritised in the event of extreme circumstances.
Other risks to people’s health and wellbeing were assessed and monitored. This included the risks associated with staff not being able to enter people’s property at agreed times. The provider had a service which people and staff could contact outside office hours, which meant that senior management were available to offer support and guidance if required.
The level of support people required around their medicines or eating and drinking was clearly defined in their care plans. Care plans were concisely written to simply reflect people’s preferences around their personal care routines. When people’s needs changed, the provider was proactive in making appropriate referrals to healthcare services, acting on changes and recommendations as required.
Risks associated with the spread of infection were assessed and monitored. Staff had received training in infection control and understood the steps needed to minimise the risk of infections spreading.
The registered manager listened to people’s feedback, complaints and concerns in order to make improvements. The registered manager was focussed on making improvements to the service’s quality and safety. They used incidents and mistakes as learning tools to promote staff’s understanding of good quality care.
There were enough staff in place to meet people’s needs. The registered manager carefully considered staffing capacity when assessing whether the service could take on additional care packages.
The provider made appropriate checks to staff candidates’ background and work history during the recruitment process. Staff received training in line with nationally recognised standards and were given ongoing support by the registered manager in their role.
People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.
Further information is in the detailed findings below.