Little Angels Home Care Services

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

While people we spoke to said that they were happy with their care, our assessment found elements of care did not meet the expected standard. We identified two breaches of the legal regulations. Throughout the inspection, the nominated individual was responsive to the findings of this inspection and open with us about the challenges in relation to the service’s recent management changes. The provider had already started to take action to address these concerns, including reviewing their policies and procedures, staff training, and reviewing care plans.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The nominated individual was open and honest about the challenges the service had been through due to changes with management. They told us they focused on delivering good quality care to people and were aware that some improvements were required in ensuring records were an accurate reflection of the work being developed. A new manager had recently joined the service and their focus was on improving some governance processes and procedures.

We found that some of the issues identified during this inspection had been identified by the provider, but others had not. We discussed with the nominated individual about the management challenges the service has been through but we could not be assured effective systems were in place to ensure adequate oversight. For example, the nominated individual and managed shared their action plan; this identified some of the areas of concern found during this inspection but not all; this action plan did not detail the actions to take, who was responsible or timescales for completion of work.

Staff told us they felt supported by management. Staff's comments included, "[Name of nominated individual] treat us like friends, we don’t have the distance between us and my manager, we speak openly with her" and " I have been working for [number of years], and [name of nominated individual] is the best boss, you can approach her, she will try to help you." The nominated individual and manager told us how they supported staff to do their jobs well and encouraged them to further develop their skills and competences.

The nominated individual was involved in delivering care and provided regular support and guidance to staff. However, this was not recorded and evidenced in supervision and appraisal records as indicated in the service's policies and procedures. Staff told us they worked well together as a team and it was easy to escalate any concerns to the nominated individual. However, the last meeting was held in November 2023. Another meeting was scheduled for May 2024.

Staff told us they felt confident in raising any concerns to the manager. Their comments included, "[Management team are] fair and approachable." The nominated individual and manager were available to speak with people, relatives, staff and healthcare professionals. Feedback we received in this area was positive.

There were policies and procedures in place that encouraged speaking up. There was a whistleblowing policy in place and this was known by staff.

Staff felt well supported by management but this was not always documented, in line with the provider's policies.

The nominated individual and manager told us how they supported staff to do their jobs well and encouraged them to further develop their skills and competences. However, this was not recorded and evidenced in supervision and appraisal records as indicated in the service's policies and procedures.

The nominated individual was open and honest about the challenges the service faced, but we could not be assured effective systems were in place to ensure adequate oversight. For example, the nominated individual and manager shared their action plan, this identified some of the areas of concern found during this inspection but not all; this action plan did not detail the actions to take, who was responsible or timescales for completion of work.

There were quality assurance processes and procedures in place but during this inspection we found these had not always been effective in identifying and addressing the issues we found with medication, recruitment and training. During this inspection, we found the provider was not always following their own policies and procedures, best practice guidance and was in breach of some regulations. The quality assurance systems in place had not always been effective. We found safe recruitments checks were not always carried out. All the staff files reviewed, had been audited by the provider and no issues had been highlighted. We found some areas of the care plans required further detail, such as risk assessments. This had not been identified during the care plan audits. This constitutes a breaches in regulation 17 (good governance).

People did not raise concerns in this area. Feedback received was that the service worked well with other professionals.

The nominated individual had established good relationships with relevant healthcare professionals and commissioners of care.

The service worked in partnership with others to meet the needs of people.

During this assessment, we found the service worked well with other professionals.

The nominated individual and manager collaborated with this inspection, was receptive to the inspection findings and acted on the issues found or told us the action they would take to address the issues identified.

During this assessment, we found a lack of evidence that accidents were recorded and analysed. In our conversations with staff, they told us about one person who had had falls and how this risk had been managed. In our review of information, we found this person's care was managed appropriately, however accidents and falls had not been recorded. After our site visit, the nominated individual told us they would implement improvements in all the areas of concerns raised during this inspection, including recording and analysing accidents and incidents.