Archived: All Care - West Berkshire

Updated 29 June 2021

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 two inspectors and two Experts 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 houses and flats.

The service had a manager registered with the Care Quality Commission. 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

This inspection was unannounced. Inspection activity started on 24 May 2021 and ended on 28 May 2021. We visited the office location on 24 May 2021.

What we did before the inspection

We spoke with members of the public who had already raised concerns with us. We reviewed information we held and had received about the service since its registration. We sought feedback from the local authority, safeguarding team and other professionals who work with the service.

We checked information held by Companies House and the Information Commissioner’s Office. We checked online reviews and relevant social media. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.

During the inspection

We spoke with eight people who use the service and thirteen relatives about their experience of the care provided. We spoke with the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with the operations manager, registered manager, two care supervisors and two care workers.

We reviewed a range of records. This included four people’s care records and medicines administration records. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. After the site visit, we requested and received further information from the registered manager about the service’s governance and training. Some staff contacted us to provide further information.

Updated 29 June 2021

About the service

All Care – West Berkshire is a community care provider providing personal care to 49 adults at the time of the inspection. This included people living with sensory impairments, physical disabilities and dementia. The service employed 27 staff which included 19 care workers.

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

There were not always sufficient suitably qualified and experienced staff deployed to safely meet people’s needs. Calls were late, shortened, missed or cancelled as a result. Both people and relatives expressed their dissatisfaction with the completion of their commissioned calls. Although some incident and accidents were recorded, many were not recorded at the time they occurred. Adults at risk of abuse or discrimination were protected from such harm by the service. Staff and the service took appropriate steps to protect people from the risk of infections, such as COVID-19.

Not all staff training was up to date. As staff had covered vacant shifts and worked some long hours, they did not have time to complete or refresh their statutory and mandatory training. People and relatives stated regular care workers knew their preferences and how they liked to be supported. However, they stated that regular changes in staff without notice meant that staff did not always know how to best support them. There were appropriate risk assessments in place related to people’s support packages.

There was mixed feedback from people and relatives about how caring the service was. However, most praised the regular care workers that supported them. They commented that they were kind and provided support in the right way. People and relatives were involved in care planning. People’s privacy and dignity was protected.

Care plans contained the necessary information to support people. They included how care should be planned, delivered and evaluated. There was a satisfactory complaints system in place.

The governance of the service was not always effective. Failure to continuously monitor increasing burden from people’s packages of care meant that personal care calls started to be rushed, missed, late or cancelled. Although people and relatives had contacted the service to complaint, they reported difficulty reaching staff by phone. Some people had resorted to ringing care workers on their own mobile phones to check whether they would receive their care. During a large staff absence on a weekend, the business continuity plan was implemented. Whilst steps were taken to meet complex care packages, other people’s care was cancelled, and relatives were asked to provide support instead. This led to frustration amongst some people and relatives involved, and a loss of trust and confidence in the service. The service worked with the local authority to ensure that people’s care needs were being met. The local authority had contacted people to ensure calls were being completed. The local authority confirmed to us after the inspection that calls were being carried out in accordance with the commissioned care.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 28 August 2020 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about staffing shortages and alleged poor communication from the service with people and relatives. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective and Well-Led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.