Assist Home Care Limited was rated Good overall following a January 2016 inspection, with care, safety, effectiveness and leadership all meeting standards. Responsive was rated Requires Improvement due to concerns about staff not completing tasks within allocated visit times, late calls, and an unresolved complaint.
Concerns (5)
moderate
Missed or late visits
: “staff have arrived as late as 2pm for a lunch time call which is not acceptable”
moderatePerson-centred care: “staff do not always stay with my relative the correct length of time and don't always ensure they have sufficient to eat and drink”
moderateComplaints handling: “The agency seem to think they have dealt with my concern. However, nothing has changed and I still find the situation I find myself in unacceptable.”
minorCommunication with families: “new staff were not always introduced to them and if their regular carer was on leave or off work sick they were not always notified in advance”
minorRecord keeping: “until recently the MAR did not record the actual medicines administered to people and staff just signed to indicate they had administered medicines as prescribed”
Strengths
· Safe recruitment procedures in place including DBS checks and two written references before employment commences
· Staff knowledgeable about safeguarding, whistleblowing policy and external reporting routes including the local authority Adult Protection Unit
· Person-centred support plans reviewed regularly and signed by service users or relatives
· Majority of staff bilingual, with cultural matching to service users and information available in multiple languages
· Quality assurance system in place with audits of support plans, risk assessments, daily records and staff files
Assist Home Care Limited was rated Good overall at its April 2019 inspection, with a Requires Improvement rating for Safe due to insufficient guidance on 'as required' medicines and inadequate instructions for the management and application of creams. All other key questions were rated Good, reflecting strong person-centred care, skilled and well-supported staff, and effective leadership with robust governance processes.
Concerns (4)
moderateMedication management: “There was insufficient guidance about administering 'as required' medicines. Information was unclear about when and why such medication should be administered.”
moderateMedication management: “There was insufficient information recorded regarding the management and application of people's creams. Instructions did not always indicate the frequency or where the cream should be applied.”
minorRecord keeping: “Call times were not always clearly recorded in people's notes. We discussed this with the registered manager and we were confident this would be addressed.”
minorCommunication with families: “We received some feedback that communication from some staff was not always clear. We discussed this with the registered manager and we were confident this would be addressed.”
Strengths
· People and relatives confirmed the service was caring and safe, with consistent staff who knew them well.
· The service employed several bi-lingual staff ensuring effective communication, with care plans and service user guides translated into Urdu.
· Care plans were detailed, person-centred, reviewed regularly and reflected individual choices and preferred routines.
· Staff received individualised training, comprehensive induction, regular supervision and spot checks to ensure competency.
· The registered manager fostered an open team culture with weekly briefings, robust audits and unannounced spot checks.
Quality-Statement breakdown (20)
safe: Using medicines safelyRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and management; learning lessons when things go wrongGood
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
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 diet
Good
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to meet people's needs, preferences, interests and give them choice and controlGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportNot rated
well-led: Planning and promoting person-centred, high-quality care and support with opennessGood
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 care; working in partnership with othersGood