Ablewell Care

Updated 11 September 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014.

The inspection took place on 9 and 10 August 2018 and was announced. We gave the service 36 hours notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

The inspection site visit activity started on 9 August 2018 and ended on 10 August 2018. It included talking to staff, talking to people who were receiving a service over the phone, reviewing records including medication administration sheets and visiting people in their own homes. We reviewed three care plans and daily records, visited two people at their own home and reviewed their documentation, spoke with eight staff, four service users over the phone and one person's next of kin.

We reviewed all the information we held about the service including the Provider Information Return {PIR} sent to us dated 6 April 2018. This is a document we ask the provider to complete about the service.

The inspection team consisted of one adult social care inspector.

During a visit to one person's home we met a community nurse who we spoke with and we also contacted other professionals who came into contact with the service such as the Local Authority Contracts and Quality team.

Updated 11 September 2018

This announced inspection took place on 9 and 10 August 2018 and was announced. It was the first rated inspection since the location was registered with CQC on 30 April 2015.

Ablewell Care is a domiciliary care service providing personal care to people living in their own houses who misuse drugs or alcohol, who had dementia, learning difficulties or autism spectrum disorders. At the time of our inspection they were providing a service for 91 people and they had 42 care staff.

A condition of registration with CQC is for there to be a registered manager in post. There was no registered manager in post at the time of this inspection. The Nominated Individual was mentoring a manager to develop into becoming registered manager in due course.

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.

We found although there were quality assurance systems in place at the time of our inspection, further improvements were required to ensure the governance was robust. For instance, not all statutory notifications had been reported to us. The submission of a statutory notification is a legal requirement when specific incidents or events had taken place in the service.

We also found safeguarding concerns were not being tracked with an outcome or analysis for trends or themes.

There was a complaints process and procedure in place however, further improvements were needed to ensure it was clearer for people what constituted a complaint. The provider had identified this from their customer feedback survey.

A recruitment audit had been completed by the provider and seven staff recruitment files only had one reference from a previous employer. The provider had therefore, identified this and were taking action to improve this.

The governance arrangements were clear with numerous quality checks in place such as monthly auditing of daily records and medication administration sheets {MARS}, recruitment practices, analysis of incidents, customer feedback and complaints.

Safeguarding concerns were being logged and reported to the Safeguarding Authority appropriately. Staff were aware of their responsibilities and were raising concern when they suspected abuse. The provider had a whistleblowing policy in place for staff to follow.

There were enough staff to deliver care for people when they needed it. People told us if the carer was running late they would phone them to inform them. Any missed visits were investigated and the root cause identified.

Medicines were being managed safely with medication administration sheets being completed. Medication errors were being recorded and analysed.

Staff were caring and were encouraging people to have as much independence as possible. People we spoke with told us they were treated with respect and dignity.

People were being asked for their consent and the service was working within the Mental Capacity Act 2005 framework.

People were receiving person centred care and were being involved in their plan of care. Likes, dislikes and preferences were being recorded.

People’s care needs were being assessed and the service were in the process of implementing the Herbert protocol which is good practice in identifying who may be at risk of becoming a missing person.

Healthcare professionals were being involved in people’s care and staff communicated with them when needed.

The provider had implemented policies in relation to Equality and Diversity and were promoting people’s rights.

The service was seeking people’s views in the form of surveys and monthly reviews. A newsletter was sent out to people to inform them of anything new or changes in the service.

The provider was seeking to encourage people to work within the health and social care sector and was working on this with other outside agencies. The culture of the service was to continuously improve for the benefit of the people needing care and support.

The service offered staff a range of training which was delivered online and in the classroom. All staff were working towards the Care Certificate or had completed it. Staff were actively encouraged to complete other qualifications in care.

Supervision and appraisals were being undertaken. Staff meetings were being held and there was an “open door policy” by the managers.