Adriel Care Limited

Updated 14 February 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection was undertaken by an inspector and an Expert 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.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service two working days’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 25 October 2022 and ended on 16 January 2023. We visited the location’s office on 25 and 28 October 2022.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, NHS commissioners and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with five relatives on the telephone and with six staff including the registered manager, who is also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We viewed two care records, four staff files and various records relating to the management of the service, including incident and accident records, staff training records, staffing rotas and quality assurance records.

Updated 14 February 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Adriel Care Limited is a domiciliary care service providing personal and nursing care to 11 adults and children at the time of the inspection.

Not everyone who uses the service receives 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

Right Support:

Since the last inspection, the service had changed the emphasis of its work, from short, practical visits to older and physically impaired adults to whole shifts with adults and children with a range of complex needs, including people with a learning disability and autistic people. Staff had received training about learning disability and autism, in line with national requirements. However, whilst care plans addressed the practical care people needed, they were structured in a way more akin to the way the service used to provide care. The registered manager recognised the service needed to develop its practice in line with current good practice for people with a learning disability and autistic people and has since the inspection implemented plans towards achieving this.

The service worked with people’s health and social care professionals to help ensure people received the support they needed. The management team recognised circumstances in which people might not be able to give valid consent to aspects of their care and had taken the appropriate action. They had identified where people could be considered as deprived of their liberty and had liaised with care commissioners, who had applied for the necessary legal authorisation.

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 required review and updating to support this practice. We have made a recommendation in relation to care and support planning for people with a learning disability and autistic people, and regarding the provider’s safeguarding policies.

Right Care:

People and their relatives were involved in the planning and review of their care and support. Care plans were individualised and reflected people’s known preferences. They clarified any support people needed with their prescribed medicines.

Right Culture:

People, relatives and staff felt able to raise concerns with the service. Concerns were taken seriously and acted upon promptly. People and, with the appropriate permission, their relatives had access to the computerised records system, which increased transparency and made the service more responsive to their comments. Managers regularly sought feedback from people, staff and relatives and acted on this to improve people’s experience of the service.

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 20 March 2018).

Why we inspected

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

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained 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 Adriel Care Limited on our website at www.cqc.org.uk.

Recommendations

At our last inspection we recommended the provider sought appropriate guidance to ensure care plans reflect the framework of the MCA. We also recommended the provider sought appropriate advice and implemented more person-centred care recording. The provider had acted on the recommendations and had made improvements in both areas.

We have made a recommendation in relation to the provider’s safeguarding policies.

We have also made a recommendation in relation to strengths-based care and support planning and positive behaviour support when the service works with people with a learning disability and autistic people.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.