Date of assessment 7 May 2025 to 4 June 2025. Ansa Care is a domiciliary care service providing support to people living in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive the regulated activity of 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 assessment 31 people were receiving the regulated activity of personal care. The service supported people living with health and neurological conditions, physical disabilities and general frailty. Some people supported had a learning disability. The provider was working in line with national best practice guidance for people with a learning disability and autistic people. The inspection was undertaken to assess improvements since the last inspection (published 31 August 2022). Improvements had been made and risks to people were now managed safely. The rating has now improved to good. Some staff did not always feel respected or treated well. Assessments for the regulated activity of personal care were not always clear. People received safe person-centred care. Safeguarding procedures protected people from abuse. Medicines were managed and administered safely. There were enough skilled staff to ensure people’s safety and meet their needs. Risk management processes supported people’s safety, independence and wishes. There was provider oversight of the service and governance systems supported good care. We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence, and good access to local communities that most people take for granted.
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Ansa Care was rated Requires Improvement overall at its first inspection due to a breach of Regulation 17 (Good governance), with risk assessments lacking detail and an alleged abuse incident not notified to CQC. People received kind, personalised care from trained staff and the four other key questions were rated Good.
Concerns (6)
criticalGovernance: “The provider had failed to fully assess, monitor and mitigate risks relating to the health, safety and welfare of people using the service.”
criticalSafeguarding: “An incidence of abuse had been reported to the local safeguarding authority, but not notified to CQC in line with regulatory requirements.”
moderateCare planning: “There was no specific information for staff about diabetes, how this affected the person, and actions staff should take in the event they had low (or high) blood sugar levels.”
moderateRecord keeping: “their assessment was unclear as to whether the risk was high, medium or low, as there was no explanation of how the final score had been calculated.”
moderateMedication management: “it stated that topical cream should be administered 'all over the body'. There was no body map to guide staff on where exactly the cream should be applied.”
minorMissed or late visits: “Some of the carers don't have a car and they come at different times. I have to ring to find out where they are. They apologise in the office and say it won't happen again, but it does.”
Strengths
· Staff were kind, caring and treated people with dignity and respect
· Personalised care plans reflected people's choices, preferences and cultural needs
· Safe recruitment processes including DBS checks and reference verification
· Staff completed induction, Care Certificate and rolling mandatory training
· Medicines were managed safely by trained staff with competency assessments
Quality-Statement breakdown (24)
safe: Systems and processes to safeguard people from the risk of 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 lawNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Staff working with other agencies; supporting people to access healthcareNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
caring: Ensuring people are well treated and supported; respecting equality and diversityNot rated
caring: Supporting people to express their views and be involved in making decisions about their careNot rated
caring: Respecting and promoting people's privacy, dignity and independenceNot rated
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesNot rated
responsive: Meeting people's communication needsNot rated
responsive: Supporting people to develop and maintain relationships to avoid social isolationNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: End of life care and supportNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated
well-led: Continuous learning and improving careNot rated
well-led: Working in partnership with othersNot rated