5 January 2023
During an inspection looking at part of the service
Angel Approved - Care at Home is a domiciliary care agency providing personal care to people living in their own homes or specialist housing. The service provides support to older people, often who live with dementia. Some people require support with their mobility. At the time of our inspection there were 14 people receiving personal care.
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
We found some areas for improvement regarding audit processes, people’s documentation, partnership working and understanding of reporting incidents. We also discussed concerns around closed culture and personal relationships between staff and the registered manager.
Although we identified these issues, staff and professionals spoke highly of the registered manager. One staff member said, “Management are really responsive, very easy to talk to and willing to listen.” Other staff talked about a strong team working ethic. One staff member said, “We all get on and are comfortable discussing things with each other. We worry about the same things.”
The registered manager was aware of current concerns within the care sector and sought external links with other services to improve quality of care.
There were enough staff to meet people’s needs and staff knew people and risks to their wellbeing. One relative told us, “They always arrive within times, apart from the odd occasion which is unusual. I think they are very reliable.” Staff had all received training in safeguarding, could recognise signs of abuse and tell us actions they would take if they had concerns. Medicines were given safely.
Staff were trained and knowledgeable. They engaged with professionals in the community, to ensure individual needs had been met. One professional said, “They always listen and take on board my professional recommendations.” Staff felt well supported in their roles with an induction and regular checks on their wellbeing.
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.
Feedback about staff from a person and relatives was positive. Staff were described as kind, caring and compassionate. People’s dignity, privacy and independence was promoted and respected.
People received personalised care. Their views, choices and preferences were at the centre of all support. Staff knew and understood how to communicate with people in line with their support needs and preferences. People knew how to complain if there were any issues and received a timely and effective response. People supported at the end of their lives were cared for with compassion. Their choices were respected by staff and action taken to ensure a comfortable and pain free death.
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
This service was registered with us on 4 April 2022 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement and Recommendations
We have identified 1 breach of regulations in relation to auditing processes, partnership working and lack of transparency at this inspection.
There was also a breach of the Care Quality Commission (Registration) Regulations 2009 where the provider had not consistently reported incidents to us.
Please see the action we have told the provider to take at the end of this report.
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.