Aapna House, a domiciliary care agency in Middlesbrough, was rated Requires Improvement overall following a focused inspection in November 2022, with breaches of Regulations 17 and 19 identified relating to record keeping, medicines management, governance, and recruitment. Despite these failings, people reported feeling safe and well-cared for, staffing levels were adequate, and infection control was managed effectively.
Concerns (7)
criticalRecord keeping — “The provider failed to have in place fully accurate, complete and contemporaneous records in respect of each service user. Breach of regulation 17.”
criticalMedication management — “Systems and procedures were not in place to ensure that people's medicines were accurately recorded. Staff did not always appropriately record why a medicine was not administered.”
criticalGovernance — “Systems were not in place to effectively assess, monitor and improve the quality and safety of the service. Breach of regulation 17.”
criticalStaff competency — “The provider failed to have safe recruitment procedures in place. The provider did not consistently obtain full employment histories or appropriate references.”
moderateCare planning — “People's care plans were not always up to date. Some care plans contained out of date information and guidance for staff.”
moderateIncident learning — “Incidents had occurred which were not included in the provider's monthly incident reports. This meant that oversight was not effective, and trends could not be identified.”
moderateMissed or late visits — “Systems were not in place to analyse key performance indicators such as late or missed calls.”
Strengths
· There were enough staff to safely support people, and staff had received suitable training to meet people's needs.
· People were kept safe from the risk of abuse; staff had received safeguarding training and understood how to recognise concerns.
· The provider effectively managed infection prevention and control; staff had access to PPE and wore it in line with national guidance.
· The provider carried out environmental risk assessments to help staff care for people safely in their own homes.
· There was a positive atmosphere within the service; people reported feeling happy, comfortable and treated like family.
Quality-Statement breakdown (8)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Using medicines safely; learning lessons when things go wrongRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Preventing and controlling infectionGood
well-led: Managers and staff being clear about their roles, understanding quality performance, risks and regulatory requirements; continuous learningRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Engaging and involving people using the service, the public and staff; working in partnership with othersGood