29 June 2021
During an inspection looking at part of the service
About the service
Assured Care (Stockport) Limited is a domiciliary care agency providing personal care to 214 people at the time of the inspection.
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 not always ensured detailed individual risk management plans were in place to guide staff on how to provide care to people with specific needs in the safest way possible. Care documentation was not always reviewed in a timely way to reflect people’s current care needs.
The provider had not ensured staff had the necessary, up to date training in place before providing care and support to people. Also, the provider had not satisfied themselves on an ongoing basis that staff providing care and support were competent to do so.
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 concerns regarding legal safeguards around decision making for people in the form of Lasting Power of Attorney (LPA).
We have made a recommendation around the lawful use of LPAs.
We received mainly positive feedback from people who used the service about the care they received and about the care staff. People felt safe and they told us staff read their care plan and staff always wore personal protective equipment (PPE) when visiting them.
Policies, procedures and audits were in place. However, they had not always been followed and audits had not identified the concerns we found on this inspection. Staff mostly felt supported in their role and felt they could report concerns to the senior staff.
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 (published 18 July 2019).
Why we inspected
The inspection was prompted due to concerns received about the management of and escalation of people’s individual risks to their health, staff training levels and non-notification of safeguarding incidents. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Assured Care (Stockport) on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to the management of people’s individual risks, staff training and governance of the service.
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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.