New Age Care

Updated 16 November 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 2014.

Inspection team

The inspection visit was completed by 3 inspectors and 1 further inspector worked off site making telephone calls to people and relatives. An Expert by Experience also made telephone to people and their relatives. 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.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

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

Notice of inspection

This inspection visit was unannounced. The first day of our inspection was unannounced. We informed the provider we would return to continue our inspection the following day.

Inspection activity started on 9 October 2023 and ended on 16 October 2023.

What we did before inspection

We reviewed the information we held, such as people and relatives’ feedback and statutory notifications, as well as any information shared with us by the local authority and commissioners. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 1 person who received a service to get their experiences about the quality of care received. We also spoke with 7 relatives. We spoke with 9 members of care staff that included office staff who supported the registered manager with audits, checks, care call scheduling, care assessments and care planning. We spoke with the owner who was the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. These included examples of 5 people’s care records, as well as associated records that included daily report logs and medicine administration records. We reviewed 4 staff recruitment files, policies and procedures and examples of quality assurance checks and meeting minutes.

Updated 16 November 2023

About the service

New Age Care is a is a community-based care provider that provides personal care to people living in their own homes. At the time of inspection, the provider told us they supported 65 people but not everyone received a regulated activity.

Forty two people were in receipt of the regulated activity of 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 received care calls ranging from 30-minutes up to 24/7 live in support.

People's experience of using this service and what we found

At our last inspection, we found significant improvements were required around managing people’s risks and risks to support safe medicines management, quality of record keeping and quality assurance processes. At this inspection, some improvements in implementing and recording audits and checks had taken place. However, in some cases, audits were not always completed on time and where some audits were completed, the provider had not identified the issues we found at this inspection which could put people at risk of harm. The provider remained in breach of the regulations.

Some care plans continued to require further information to ensure they supported person centred care. Some risk assessments although completed, needed additional information to ensure the overall risks were fully documented. Speaking with staff, this showed us staff knew people's needs and how to manage known risks.

Serious incidents had not always been fully investigated, reported and reviewed to ensure people remained safe. Some safeguarding concerns were not fully investigated and referred to us or other agencies to keep people protected.

People did not always receive their prescribed medicines safely. Systems to support safe medicines practices needed further improvement. Medicine Administration Records (MAR) did not always accurately record what doses people were administered or if those medicines were given in line with manufacturers guidelines. In some examples, people who required ‘as and when’ medicines did not have a detailed protocol in place to tell staff, when, how and what dose, these medicines should be given safely.

Improvements to monitor and organise staff training, staff development and monitoring staff competency had improved since our last visit.

Whilst we found continued issues related to record keeping and a lack of quality assurance, people and relatives spoke highly of the service they received. People and their relatives told us they had built good relationships with those staff who cared for them, and they explained how the service they received, supported positive outcomes.

People told us they received their care at the right times and people said they were supported by a consistent staff team.

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. However, we found inconsistencies in the records to evidence where family members had authority to speak on their family members behalf. We also found inconsistencies in how people’s mental capacity was supported, especially if a person’s capacity to make certain decisions varied.

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 inadequate (published 05 April 2023) and there were breaches of regulation. Following the last inspection, we requested that the provider sent us an action plan telling us what they had improved. At this inspection, we found the provider remained in breach of regulations.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. The providers action plan told us what they would do and by when to improve.

This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

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 changed from inadequate to requires improvement. 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 New Age Care on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safety and oversight of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

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

The overall rating for this service is ‘Requires improvement’. However, the service remains in 'special measures'. We do this when services have been rated as 'Inadequate' in any Key Question over two consecutive comprehensive inspections. The ‘Inadequate’ rating does not need to be in the same question at each of these inspections for us to place services in special measures. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.