Annies Homecare Limited is a domiciliary care agency delivering personal care and support to people in their homes. At the time of our inspection 48 people were being supported by the service. 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. The provider was previously in breach of the legal regulations in relation to safe care and treatment, and good governance. We carried out an announced on-site inspection on 24 June 2025, offsite activity started on 18 June 2025 and ended on 02 July 2025. We found the provider had made improvements and was no longer in breach of the regulations. The registered manager now had robust systems in place to monitor the service, which provided good oversight to monitor and improve outcomes for people and gave a clear oversight of risk. During the inspection site visit we spoke with the registered manager and the senior management team, we received feedback from 2 people who used the service, 3 relatives, 1 external professional and 8 support workers. The senior management team had developed systems to help ensure people received a good standard of safe care and support with risks being managed safely. The provider had introduced a digital care planning system; this meant the management team had a ‘real time’ oversight of the care activity. The team worked with external professionals to help ensure people received the right care and any additional support. The management team provided support and guidance for the staff team. Support workers received appropriate training and supervision. People, relatives, and staff had opportunities to share their views. We were told the management team were responsive and helpful. Staff were positive about the service they provided, the management team and liked working for Annies Homecare Limited.
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Annies Homecare Services received an overall rating of Requires Improvement following a focused inspection in October 2023, with the well-led domain rated Inadequate due to persistent, repeated breaches of Regulation 17 (Good Governance) across four of the last five inspections. Enforcement action was taken under Regulation 12 for continued failure to assess and manage risks to people's safety, while governance, care planning, safeguarding notifications, and staff culture remained significant concerns.
Concerns (10)
criticalGovernance: “The provider has been rated as requires improvement or inadequate in the well led domain for 4 of the last 5 inspections with repeated breaches of regulation 17.”
criticalSafeguarding: “We found not all concerns had been raised with CQC where appropriate.”
moderateCare planning: “People's care plans were not always personalised or detailed. This meant there was a risk people may not receive care in their preferred way.”
moderateRecord keeping: “Supervision and appraisal records were poorly completed and it was not always clear when staff supervisions had taken place.”
moderateIncident learning: “There was no analysis to identify and understand any trends or themes to drive improvement. This was also identified as an issue at the last inspection.”
moderateEnd-of-life care: “We found 1 person's care plan had not been updated to reflect they were now receiving end of life care.”
moderateSupervision / appraisal: “Supervision and appraisal records were poorly completed and it was not always clear when staff supervisions had taken place.”
moderateLeadership: “You don't always get feedback when you report something. There's terrible communication and you're too scared to say anything. You're made to feel uncomfortable.”
moderatePerson-centred care: “The provider did not always empower people to have choice and control over the timing of their care visits.”
minorComplaints handling: “It was not always clear what actions they had taken or how the complaint had been resolved.”
Strengths
· Provider implemented an electronic medicines administration system enabling real-time monitoring and improved medicines safety.
· Sufficient staffing levels achieved; electronic call monitoring system introduced to track visit attendance and respond to missed or late visits.
· Infection prevention and control processes improved; staff trained and PPE available.
· Provider worked in partnership with healthcare professionals who reported responsive communication.
· Improvements made to gathering feedback from people and relatives, including satisfaction surveys and regular phone calls.
Quality-Statement breakdown (13)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Using medicines safelyGood
safe: Staffing and recruitmentRequires improvement
safe: Safeguarding and learning lessons when things go wrongRequires improvement
safe: Preventing and controlling infectionGood
responsive: Planning personalised care to ensure people have choice and controlRequires improvement
responsive: Improving care quality in response to complaints or concernsRequires improvement
responsive: End of life care and supportRequires improvement
responsive: Meeting people's communication needsGood
well-led: Managers and staff being clear about their roles, quality performance, risks and regulatory requirementsInadequate
well-led: Promoting a positive, open, inclusive and empowering cultureInadequate
Annies Homecare Services received a Requires Improvement rating following a focused October 2022 inspection, with regulatory breaches found across safe care and treatment (Reg 12), staffing (Reg 18), and good governance (Reg 17), the latter resulting in a warning notice. Key failures included missed and short visits due to staff shortages, unsafe medicines management, outdated risk assessments, and an ineffective governance framework that failed to identify or address these concerns.
Concerns (9)
criticalStaffing levels: “"They do not have enough staff to provide appropriate care. [Person] doesn't always get their full time, some [staff] are in and out in 10 minutes"”
criticalMissed or late visits: “People had experienced missed and late care visits and this had not always been promptly identified by the provider.”
criticalMedication management: “We found recording errors on one person's administration record for an important medicine, which had not been identified by the provider.”
criticalGovernance: “The provider's systems for monitoring the quality and safety of the service were not effective and had failed to identify the concerns we found during the inspection.”
moderateCare planning: “We found a risk assessment which had not been updated to reflect a change in a person's mobility and one which had not been updated to reflect a change in how a person was supported.”
moderateIncident learning: “There were no minutes recorded for their team meetings and the supervision notes viewed lacked detail. This meant it was difficult to evidence how lessons learnt were being discussed.”
moderateCommunication with families: “"We have not been contacted for feedback or if we require any changes," and "I have never been asked for feedback."”
moderateRecord keeping: “People's medicines records were not always collected regularly from people's homes and this meant the management team were not able to review them to ensure no errors had been made.”
minorInfection control: “We received mixed feedback about whether staff were using appropriate personal protective equipment [PPE] when providing care.”
Strengths
· Staff were aware of how to keep people safe from harm and had received training in safeguarding.
· The provider worked in partnership with other health professionals including the local hospice, GPs and pharmacy.
· Staff told us they generally felt supported and able to raise concerns with the management team.
· Staff were supported to undertake relevant training as part of their induction and given opportunity to shadow experienced workers.
· The provider was aware of their responsibilities in relation to the duty of candour.
Quality-Statement breakdown (8)
safe: Staffing and recruitmentRequires improvement
safe: Using medicines safely; Assessing risk, safety monitoring and managementRequires improvement
safe: Preventing and controlling infectionRequires improvement
safe: Systems and processes to safeguard people from the risk of abuse; Learning lessons when things go wrongRequires improvement
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 empoweringRequires improvement
well-led: How the provider understands and acts on the duty of candourGood