Angelus Homecare improved from Requires Improvement to Good following a focused inspection of safe, effective and well-led domains, having remediated prior breaches of regulations 17 and 18. The registered manager drove meaningful improvements across governance, staff training, communication and care consistency since the previous inspection in June 2021.
Strengths
· Registered manager made significant improvements since last inspection, resolving breaches of regulations 17 and 18
· Consistent and timely care calls with people reporting staff arrive promptly
· Safe recruitment processes including DBS checks and shadowing before solo working
· Tailored in-house training programme aligned to Care Certificate standards with competency assessments
· Electronic care planning system enabling real-time monitoring of call times, durations and medicines administration
Quality-Statement breakdown (17)
safe: Staffing and recruitmentGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Staff support: induction, training, skills and experienceGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
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: Ensuring consent to care and treatment in line with law and guidanceGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving careGood
Angelus Homecare received an overall rating of Requires Improvement at its first CQC inspection, with breaches of Regulation 17 (governance) and Regulation 18 (staffing) identified due to ineffective audit systems, significant medication record gaps, and inadequate staff training and induction. The newly appointed manager was praised for their positive impact and responsiveness during inspection, with safe, caring and responsive domains all rated Good.
Concerns (7)
criticalStaff training: “I received 30 mins of training in the office on the first day, then that was it, I was sent out to work”
criticalStaff competency: “One lady nearly fell out of a hoist. I was sent out without any training”
criticalGovernance: “on one person's medicines administration record (MAR) between 1 March and 25 April 2021, there were 29 missing staff signatures”
moderateRecord keeping: “The provider's MAR chart format was not in line with best practice recommendations. The format used did not ensure each individually prescribed topical cream was separately listed”
moderateMedication management: “on one person's MAR for 1 February to 28 February 2021, there were six days where there were no recordings for the administration of the three topical creams prescribed”
moderateSupervision / appraisal: “There was no training or induction programme for the manager or senior staff. This meant that there was no clear structure of support to help integrate the new manager”
minorStaffing levels: “there was a reliance on the manager and care coordinator to deliver a significant number of care calls... impacted on the time they could spend carrying out their role overseeing the service”
Strengths
· Safe recruitment processes in place with appropriate background checks carried out before employment
· Electronic call monitoring system to reduce risks around missed or late calls
· People told us staff treated them with dignity and respect during personal care
· Care plans reflected people's needs and preferred routines; people were involved in developing and reviewing them
· New manager praised for open, hands-on and engaging approach by people, relatives and staff
Quality-Statement breakdown (23)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Staff support: induction, training, skills and experienceRequires improvement
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: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
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 ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
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 empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staffRequires improvement
well-led: Continuous learning and improving careGood