The Office

Updated 22 February 2022

The inspection

We carried out this performance review and assessment under Section 46 of the Health and Social Care Act 2008 (the Act). We checked whether the provider was meeting the legal requirements of the regulations associated with the Act and looked at the quality of the service to provide a rating.

Unlike our standard approach to assessing performance, we did not physically visit the office of the location. This is a new approach we have introduced to reviewing and assessing performance of some care at home providers. Instead of visiting the office location we use technology such as electronic file sharing, emails and phone calls to engage with people using the service and staff.

Inspection team

The inspection was carried out by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave a short period of notice for the inspection. This was because we needed to be sure the registered manager would be available to support the inspection.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all of this information to plan our inspection.

During the inspection

This performance review and assessment was carried out without a visit to the location’s office. We used technology to enable us to engage with people using the service and staff, and electronic file sharing to enable us to review documentation.

Inspection activity started on 6 January 2022 and ended on 28 January 2022.

We spoke with one person using the service and one relative about their experience of the care provided. We also spoke with one professional who works with the service and the registered manager. In addition, we received written feedback from three care staff, known as personal assistants and another professional.

We reviewed a range of records. This included two people’s care records, medication records, two staff files in relation to recruitment checks and a variety of records relating to the management of the service, including quality monitoring audits, meeting minutes and policies and procedures; so we could corroborate our findings and ensure the care and support being provided to people were appropriate for them.

Updated 22 February 2022

About the service

The Office (AKA Personal Assistant Care Agency Ltd PACA) is a domiciliary care service registered to provide personal care to people living 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.

At the time of our inspection four people were using the service. Of these, two were receiving 24-hour personal care in their own homes and had a range of care needs including learning and physical disabilities.

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

We (CQC) expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

Based on our review of the safe, effective and well-led key questions, the service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

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.

People’s rights were respected, and staff supported them to be as independent as possible.

Everyone told us the care and support provided by staff was kind, compassionate and personalised. One person described regular care staff as, "The best carers they had ever had," and "Just brilliant." Recruitment was ongoing to ensure there were always enough staff to cover leave and absence.

Staff understood how to respond to concerns about abuse and harm. Staff had been trained to support people with their medicines in a safe way and they understood the importance of good hygiene and the prevention and control of infection.

Staff had the right training and skills to carry out their roles and meet people’s needs. They made sure people had enough to eat and drink, and if anyone became unwell, staff knew how to access health care services to support people’s health and wellbeing.

There was positive feedback about the registered manager, who people described as approachable and helpful. The registered manager had worked hard and invested in a new electronic records system, to make a number of improvements across the service since the last inspection.

However, we found some of these improvements were only recent, and more time was needed to implement them fully. This included the completion of a new monitoring audit that would allow the registered manager to check the quality of the service in all the areas that we (CQC) look at when we inspect registered services.

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

The last rating for this service was requires improvement (published 21 April 2020) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

This service has been in Special Measures since April 2020. During this inspection the provider demonstrated that improvements have been made. The service is no longer in breach of regulations or rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

However, the service remains rated requires improvement. This is based on the findings at this inspection. We could not improve the overall rating on this occasion because to do so requires consistent good practice over time. We will check this again at our next planned comprehensive inspection. This means the services has been rated requires improvement for the last four consecutive inspections.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions: safe, effective and well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Office on our website at www.cqc.org.uk.

This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, plus phone calls and emails to engage with people using the service as part of this performance review and assessment.

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.