1 March 2022
During an inspection looking at part of the service
About the service
This domiciliary care service is owned by Archangel Enterprises Limited and is registered to provide personal care to adults within their own homes. The agency offers support primarily to people with a learning disability mainly within the Winsford and Northwich areas of Cheshire. The service is run from an office situated on the outskirts of Winsford. The service provides care and support to both people living in 'supported living' settings and people living in their own home. Supported living settings are designed so that people can live in their own home as independently as possible. 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 our visit 57 people were being supported by the service.
People’s experience of using this service and what we found
Right Support
Improvements were required so everyone receiving support could develop and pursue their interests.
People were supported by staff who had the skills and knowledge to meet their individual needs.
Competent staff supported people to manage their medicines. Medicine care plans clearly described people’s individual needs.
People were supported to participate in some activities of their choice. Some people and their relatives did not feel they had enough opportunities to undertake activities of their choice.
People were supported with their communication. Staff understood and supported people with their individual communication styles. Information was not consistently made available in accessible formats, such as, easy read and pictorial.
Staff supported people to make decisions following best practice in decision making. People were offered some daily choices and staff respected people’s views.
Right Care
Risks associated to people’s care and choices were set out in their care records, but improvements were required to ensure all risks were individual to the person, held sufficient detail and were regularly reviewed.
People were not always supported by a consistent staff team. This was due to a high turnover of staff. Staff and relatives told us this impacted on people’s lives.
People received compassionate care from staff they described as kind. Staff respected people’s privacy and dignity.
Right Culture
Some staff had left recently and the remaining staff team were stretched to ensure sufficient staffing levels were maintained.
Some people and those important to them were not always involved in planning and reviewing their care. The registered manager was working to address this.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
We undertook this inspection to assess that the service is applying the principles of right support, right care, right culture.
The inspection was prompted in part due to concerns received about staffing levels, areas of risk relating to moving and handling and opportunities for people to undertake purposeful activities. A decision was made for us to inspect and examine those risks.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in regulation relating to risk management and governance.
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.
We will request an action plan from 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.