Date of assessment: 23 October to 14 November 2025. Archangel Home Care is a domiciliary care agency. It is registered to provide personal care to people over the age of 18 years, living in their own homes. Not everyone who used the service received personal care. CQC only assesses services where people receive personal care. This is help with tasks related to personal hygiene and eating. At the time of this assessment there were 4 people receiving personal care. There was a registered manager in post. A registered manager is a person who has registered with the CQC to manage the service. This means that they and the provider are legally responsible for how the service operates. This was an announced assessment because the service was small, and we needed to ensure the registered manager would be available to support the assessment. Archangel Home Care was last rated requires improvement (published 25 June 2019). At that time, the provider was in breach of the legal regulation in relation to quality monitoring and governance. This assessment looked at all quality statements within all key questions. At this assessment Archangel Home Care was rated good. We 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. Whilst the manager was unaware of this guidance, the principles of ‘Right support, right care, right culture’ were met for all people who received support from Archangel Home Care. Right Support: People were encouraged to lead their lives in their chosen way and were supported to access activities in the community. Staff involved people in decisions and planning any changes to their care, independence was encouraged and supported. Staff did not restrict people, they understood and managed risks. The policies and systems in the service supported this practice. There were enough staff, and where gaps were identified in training to support people with a learning disability or autistic spectrum disorder, this was addressed immediately after the assessment. Staff described care they provided, which suggested they did have the skill and understanding to support all people. The registered manager made sure staff received regular supervision to maintain high-quality care. Staff followed safeguarding procedures and demonstrated an understanding of how to raise concerns both internally and externally. There were systems to review incidents and accidents. People told us care was timely; however, oversight of staff deployment was not always adequate. Right Care: People were treated with kindness and compassion and received dignified care that respected their privacy and human rights. Care and support were person-centred and holistic. Individualised care and support plans were in place that enabled staff to provide person centred, outcome focussed, and safe care for each person. People’s preferred communication styles were known, and staff were skilled in supporting people with their communication needs. The manager was proactive in addressing gaps in policy and procedure identified about communication and accessibility during the assessment. Right Culture: People, their relatives and staff believed their views and feedback were valued, respected and consistently used to support quality service development. The ethos, values, attitudes and behaviours of leaders and care staff ensured people supported by Archangel Home Care led confident, inclusive, and empowered lives. Staff and managers had shared values which were based on supporting people to live an ordinary life as any other citizen with the same rights and opportunities. The registered manager undertook a range of audits to check on the quality of care provided; however, action was not always taken when concerns were identified . Relatives and staff felt the leadership of the service was effective and encouraged people to be involved in their care. The provider was previously in breach of legal regulation in relation to leadership and governance. The service had made improvements and is no longer in breach of regulations.
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Archangel Home Care Nottingham Branch was rated Good overall following a February 2016 inspection, with four people receiving personal care in their own homes. The single area of Requires Improvement related to the Mental Capacity Act 2005 not being consistently followed, with decisions made for a person without completing mental capacity assessments or best-interest documentation.
Concerns (2)
moderateConsent / capacity: “Some decisions had been made for a person without following the legal framework to consider if the person was able to make these decisions for themselves.”
moderateRecord keeping: “One person's relative had signed some areas of a person's support plan instead of the person...had not determined if the person would have been able to do this for themselves.”
Strengths
· People felt safe and trusted staff, with consistent staff allocation promoting stability and relationship-building.
· Staff were trained, enrolled on the Care Certificate and professional diplomas, and received regular supervision and appraisal.
· People were involved in planning and reviewing their care, with person-centred support plans praised by external professionals.
· Responsive complaints handling with two complaints in the preceding year appropriately resolved.
· Well-ordered office and filing systems with regular audits to monitor service quality.
Archangel Home Care deteriorated from Good to Requires Improvement since its last inspection in 2016, with a breach of Regulation 17 cited due to ineffective governance, inconsistent risk assessment recording, significant staff training gaps, and irregular supervision and appraisals. People experienced kind, compassionate care from staff who knew them well, and medicines were managed safely, but leadership capacity was overstretched and monitoring systems were insufficiently robust.
Concerns (9)
criticalGovernance: “This was a breach of Regulation 17 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.”
moderateRecord keeping: “Risks associated with people's needs had been assessed, but not fully explored to ensure all risks were managed in a safe way.”
moderateIncident learning: “There was no process to analyse accidents and incidents to monitor themes and trends to reduce reoccurrence.”
moderateInfection control: “Staff confirmed they had not had any up to date training on infection control...only two staff had completing the training for infection control.”
moderateStaff training: “11 staff had not completed challenging behaviour training. 14 staff had not completed training for complaint handling, Equality and diversity, food hygiene and risk assessments.”
moderateSupervision / appraisal: “Staff supervision had not taken place on a regular basis...supervision; spot checks and annual appraisals were not always completed or recorded.”
moderateStaffing levels: “Staff told us there was a new person coming to live at the shared living accommodation and they were concerned about the number of staff.”
moderateLeadership: “Staff felt the registered manager was not approachable or fully supportive. They also told us they felt the management of the service was disorganised.”
minorComplaints handling: “They dealt with complaints and concerns as they arose but did not always record the outcome...we could not identify if the complaint was dealt with appropriately.”
Strengths
· People felt safe and staff had a good understanding of safeguarding responsibilities; all safeguarding referrals were reported to the relevant team.
· Medicine administration records were completed accurately and people received their medicines as prescribed and on time.
· Staff were kind, caring and compassionate; people and relatives consistently praised staff attitude and relationships.
· Care was personalised with 'about me' documents, weekly planners and activities reflecting individual preferences and goals.
· The service worked within the principles of the Mental Capacity Act 2005 with appropriate MCA assessments and consent processes.
Quality-Statement breakdown (24)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Preventing and controlling infectionRequires improvement
safe: Learning lessons when things go wrongRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Staffing and recruitmentRequires improvement
safe: Using medicines safelyGood
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the law
Good
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Adapting service, design, decoration to meet people's needsGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
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: Improving care quality in response to complaints or concernsRequires improvement
responsive: Planning personalised care to meet people's needs, preferences, interests and give them choice and controlGood
responsive: End of life care and supportGood
well-led: Planning and promoting person-centred, high-quality care and support with openness; duty of candourRequires improvement
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Engaging and involving people using the service, the public and staffRequires improvement
well-led: Continuous learning and improving careGood