Anrapheal Care Agency Limited achieved a Good rating across all five key questions at its March 2023 inspection, having previously received insufficient evidence to rate at its May 2022 inspection. The service demonstrated safe recruitment, effective care planning, person-centred practice, and strong leadership engagement with staff, people and external partners.
Strengths
· Appropriate risk management plans and risk assessments in place covering falls, mental health, and home environment suitability.
· Safe recruitment procedures including DBS checks, references, qualifications, and right-to-work verification.
· Staff received induction, Care Certificate training, regular supervisions and unannounced spot checks at least monthly.
· Registered manager maintained a working relationship with local pharmacy and had medicines management processes in place.
· Person-centred care plans capturing equality, diversity, cultural, religious and communication needs with regular reviews every 3 months.
Quality-Statement breakdown (23)
safe: Assessing risk, safety monitoring and management; Systems and processes to safeguard people from the risk of abuseGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely care; Supporting people to live healthier livesGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversity; Supporting people to express their viewsGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving careGood
safe:Insufficient evidence to rateeffective:Goodcaring:Insufficient evidence to rateresponsive:Insufficient evidence to ratewell-led:Insufficient evidence to rate
First inspection of a newly registered domiciliary care agency supporting only one person at the time, resulting in an overall 'Insufficient evidence to rate' outcome with Effective rated Good. Care planning, governance audits and consistency of staffing were areas needing development, alongside a recommendation to meet the Accessible Information Standard.
Concerns (7)
moderateStaffing levels: “sometimes the service was not able to provide consistent staffing for people which did cause problems”
moderateStaff competency: “sometimes they send [a new carer] and I'm having to do the training, I'm having to explain what dementia is”
moderateGovernance: “The provider was in the process of implementing systems of audit but these were not fully implemented at the time of the inspection”
minorCare planning: “some aspects of the plan lacked information on people's exact preferences for care...some important information about people's family lives was not included”
minorCommunication with families: “One family told us they did not always know who was coming and at times were not told of changes.”
minorMedication management: “assessments were not always clear about whether it was staff or the person receiving care who had responsibility for managing medicines”
minorOther: “The service was not fully meeting the AIS...there was not a clear process for identifying when people may need information provided to them in alternative formats.”
Strengths
· Safer recruitment processes including DBS checks and full work history
· Strong staff induction and training, with competency observations in place
· Effective support for eating and drinking, including exceptional measures to meet dietary preferences
· Working within the principles of the Mental Capacity Act 2005
· Good partnership working with hospitals and residential care homes to ease transitions
Quality-Statement breakdown (19)
safe: Systems and processes to safeguard people from the risk from abuseNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Staffing and recruitmentNot rated
safe: Using medicines safelyNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support, training, skills and experience
Good
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies; supporting people to access healthcareGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityNot rated
caring: Supporting people to express their views; respecting privacy, dignity and independenceNot rated
responsive: Planning personalised careNot rated
responsive: Meeting people's communication needsNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
well-led: Promoting a positive, person-centred culture; working in partnership with othersNot rated
well-led: Managers and staff being clear about roles; quality, risk and continuous learningNot rated
well-led: Engaging and involving people, families and staff; duty of candourNot rated