Archangel Home Care was rated Requires Improvement overall, with breaches of Regulation 12 (Safe Care and Treatment) and Regulation 17 (Good Governance) identified due to generic/incomplete risk assessments and weak quality assurance systems. Staffing turnover affected continuity and people's access to chosen activities, though medicines, safeguarding, infection control and complaints handling were managed well.
Concerns (10)
criticalCare planning: “Some risk assessments were generic and did not reflect individual's needs. Some risk assessments did not contain people's names, and some held incorrect names.”
critical
Care planning
: “Within each person's care plan file there was an environmental risk assessment. Each one was blank.”
criticalGovernance: “The provider had failed to have robust systems and processes to assess, monitor and improve the service.”
moderateGovernance: “The provider had not notified the CQC when they had experienced a significant COVID-19 outbreak resulting in a very high level of staff absence”
moderateStaffing levels: “Staffing is a huge issue. There aren't enough staff to support [Name] to undertake activities”
moderateStaffing levels: “Some staff had left recently and the remaining staff team were stretched to ensure sufficient staffing levels were maintained.”
moderatePerson-centred care: “Terminology within some documents was outdated and not person centred. This was mostly within documents used to describe people's behaviour and relating to continence needs.”
moderateRecord keeping: “out of date language relating to people's health conditions, missing names on documentation and incorrect names on documents.”
minorCommunication with families: “Documents were not all available in formats suitable for people supported. For example; pictorial or easy read.”
minorSupervision / appraisal: “Not all staff knew who their supervisor was due to the number of recent staff changes at the office.”
Strengths
· Competent staff supported people to manage their medicines safely with fully completed MAR charts and PRN protocols
· Effective infection prevention and control measures with appropriate PPE use
· Safe recruitment practices followed for all staff
· Staff knew people well, understood safeguarding and how to report concerns
· Care plans were mostly person-centred with one-page profiles capturing likes, dislikes and preferences
Quality-Statement breakdown (15)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
responsive: Planning personalised care to ensure people have choice and controlGood
responsive: Meeting people's communication needsRequires improvement
responsive: Supporting people to follow interests and take part in activitiesRequires improvement
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportNot rated
well-led: Promoting a positive culture; Continuous learning and improving careRequires improvement
well-led: Duty of candourGood
well-led: Managers and staff being clear about their rolesGood
well-led: Engaging and involving people, the public and staffRequires improvement