Ave Maria Care Services

Ave Maria Care Services is a domiciliary care service providing personal care to people living in their own houses and flats. At the time of our inspection, there were 54 people receiving support in their own homes.

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

The provider had failed to adequately manage calls to ensure they were made at the agreed time. The provider had systems in place to monitor calls times which had identified these issues. However, at the time of the inspection actions taken had not been effective in addressing the issues of calls being made either earlier or later than the times arranged and agreed with people.

The provider was open and receptive to the Inspection and the findings shared with them. The management team acknowledged improvements were required and were taking additional actions with staff to address these areas.

The provider had systems in place to assess the risks to the health and safety of people and provide staff with detailed guidance to mitigate these risks and people told us they felt safe with the support of staff.

Staff adhered to infection control procedures and protected people from the risk of infection. Staff were knowledgeable in safeguarding adults' procedures. People we spoke with said they felt safe with the care and support of staff.

People were supported to have maximum choice and control of their lives and to ensure staff supported them in the least restrictive way possible and in their best interests.

Staff were caring and respectful and people were involved in their care and their wishes about how they wanted to be supported.

People we spoke with said staff provided good care and staff working for the provider told us they felt supported in their role.

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

Rating at last inspection

The last rating for the service was good (published 12 October 2017).

Why we inspected

The inspection was prompted in part due to concerns received about the management of calls. 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 responsive and well-led sections of this full report to see what actions we have asked the provider to take.

Enforcement

We have identified a breach in relation to good governance.

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.

Ave Maria Care Services is a home care agency providing personal care to 61 people aged 65 and over at the time of the inspection.

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

We received concerns about how staff were preventing the spread of COVID-19 when supporting people in their homes. We found the provider had not introduced regular COVID-19 testing for staff. We have made a recommendation about this.

We found that people were protected from the risk of acquiring infections. Staff had access to Personal Protective Equipment (PPE) and wore this in line with national guidance.

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

Rating at last inspection

The last rating for this service was Good. (Report published 15 August 2018)

Why we inspected

We undertook this targeted inspection to check on a specific concern we had about infection control. The overall rating for the service has not changed following this targeted inspection and remains good.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

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.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. At the time of our inspection 51 people were receiving personal care from the provider.

Not everyone using Ave Maria receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

There was a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.’

People were supported by staff who were aware of their responsibilities to raise any concerns they may have in terms of people’s health and wellbeing. Where safeguarding concerns had been raised, they had been responded to an acted on appropriately.

Staff were aware of the risks to people and provided with information to assist them in managing those risks. People were supported to take their medicines as prescribed and staff competency checks were in place to ensure staff followed correct procedures.

New systems had been introduced to ensure staff were provided with travel time between calls. Calls were monitored to ensure staff arrived and left at the correct time. Accidents and incidents were inconsistently reported and the provider was putting systems in place to address this.

Pre-assessment processes in place provided staff with the information they needed to support people effectively and to meet their needs. Staff had received and induction and training that provided them with the skills to meet people’s needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff presented as kind and caring and were respectful of people’s choices. People’s preferences were taken into account to ensure their dignity was maintained.

People were supported by staff who knew them well and what was important to them. People were supported to maintain their independence and encouraged to take part in activities they enjoyed.

The provider was responsive to people’s requests to change the time of some of their calls as staff worked in particular areas, providing them with the flexibility to accommodate these requests.

There was a system in place to record people’s complaints. People preferred to speak to their carers direct with any concerns, rather than contact the office.

Audits were in place to assess the quality of care but there was a lack of analysis of this information which would identify trends and help improve service delivery. New technology had been purchased to improve the quality and delivery of service. Staff felt supported and listened to. Efforts were made to obtain feedback from people who used the service.

Since that inspection we received information about concerns in relation to the service. These related to people being not being supported safely by care workers. People’s care calls were late or were missed. Some people’s medicines had not been given on time or not at all and the service did not respond to people’s complaints. As a result we undertook an unannounced focused inspection on 1 August 2017 to check whether people were safe and whether the service was well-led. This report only covers our findings in relation to these two key areas.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Ave Maria Care Services on our website at www.cqc.org.uk.

Ave Maria Care Services is registered to provide personal care and support to people living in their own homes. At the time of our visit, the service provided care and support to 55 people.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered provider’s, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us there was enough care staff to provide their care and they felt safe with them. People we spoke with told us overall, they were happy with the quality of service they received.

All staff had completed safeguarding adults training and they knew what action to take if they thought a person was at risk. The registered manager was aware of their responsibilities to keep people safe.

Staff had received training which provided them with the knowledge and skills needed to support people to move safely.

Risk assessments were in place but not all known risks had been assessed. Information in care records did not consistently provide staff with the information they needed to keep people and themselves safe when providing care to people. However, staff demonstrated their understanding of the risks associated with people’s care and how these were to be managed.

People received their medicines when they needed them.

All the people we spoke with and records we reviewed showed people’s care calls had taken place. However, some people were dissatisfied because care staff did not always arrive when they expected them. The scheduling, planning and monitoring of calls requires improvement.

There were systems in place to monitor the quality and safety of the service provided to people. However, not all checks were effective.

Recorded complaints had been responded to in line with the provider’s procedure.

The registered manager welcomed feedback from people and their families to improve the service they received.

Staff told us they had received awards for providing good quality care to people and were pleased their commitment and hard work was being recognised by the registered manager.

The registered manager was aware of which notifications they were required to send us by law so we were able to monitor any changes or issues at the service.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Ave Maria Care Services is registered to provide personal care and support for adults living in their own homes. At the time of this inspection visit, the service provided care and support to 55 adults.

There was a registered manager in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The registered manager demonstrated an understanding of the importance of effective governance processes. There was a quality monitoring system to enable checks of the service provided to people and to ensure they were able to express their views so improvements could be made. However the planning and scheduling of visits required some improvement as people who used the service regularly experienced late calls.

The service reduced the risk of people being harmed and from potential abuse because the safety of people who used the service was taken seriously. Managers and staff were aware of their responsibility to protect people’s health and wellbeing. There were systems in place to ensure that risks to people’s safety and wellbeing were identified and addressed. Staff understood the various types of abuse, what signs to look for and knew how and who to report any concerns to. Staff also knew what action they needed to take to minimise any potential risk of harm caused through an injury or accident to keep people safe. There were appropriate arrangements in place to ensure peoples’ medicines were obtained and, where appropriate, people were supported to take their medicines safely.

Although people told us they did not always receive consistent support from the same staff, they felt staff had the skills and knowledge to meet their individual needs. Staff were recruited in a safe way and employment checks were completed before they started to work for the service. There were sufficient staff numbers on duty to meet the support needs of people who used the service. Agency staff were not used as it was recognised this could have a negative impact upon people who received the service. Staff received training and supervision and there were support processes in place to monitor their practice. Staff training was monitored and provided when specific individual needs were identified. Staff were happy with the quality of the training and were keen to learn and improve their knowledge base in order to provide effective care.

People had been involved in decisions about their care and received support in line with their care plan. Relatives were also involved in how their family member’s care was planned and delivered. People were encouraged to make choices in the support they received. Staff understood that people have the right to refuse care and that they should not be unlawfully restricted. The provider knew what appropriate action should be taken to protect people’s legal rights. Staff supported people to have drinks and, where appropriate, meals that they enjoyed.

Peoples’ needs were being met because the service worked in partnership with health and social care professionals to meet those needs. Health professionals we spoke with were happy with the standard of care provided although one professional was concerned with the inconsistency of care staff. Staff were caring, kind and treated people with dignity and respect. People’s choices and independence was respected and promoted and staff responded to people’s support needs. People, relatives and staff felt they could speak with the provider about their worries or concerns and felt they would be listened to.