Angels Care Agency Limited received an overall Good rating at its first inspection, with people praising the kind, consistent and person-centred care from regular staff. However, Safe was rated Requires Improvement due to gaps in risk assessments, medicines records, COVID-19 PCR testing and governance audits that had failed to identify these concerns.
Concerns (12)
moderate
Medication management
— “Their care plan noted this was a prescribed medicine, however we found no medicine administration record (MAR) was in place.”
moderateRecord keeping — “Some MAR records were not completed in line with best practice guidance. For example, MAR records did not include the person's date of birth.”
moderateCare planning — “We also identified the absence of a robust risk assessment in relation to one person's use of bed rails and the absence of risk assessments in relation to one person's diagnosis of diabetes”
moderateInfection control — “Staff feedback and records showed uptake of weekly COVID-19 PCR tests had been variable.”
moderateGovernance — “audits had failed to identify all of the concerns we found in relation to risk assessments and medicine records.”
minorSafeguarding — “The policy, which included guidance about recognising signs of abuse, and staff handbook did not include self-neglect and modern slavery.”
minorStaff competency — “The service did not have formal observational competency assessments documented in areas such as medicines administration and infection control.”
minorSupervision / appraisal — “One staff member's supervision record showed a gap in sessions between March 2021 and September 2021.”
minorStaff training — “two members of staff employed since February and May 2021 had not completed the Care Certificate.”
minorConsent / capacity — “We recommend the service monitors and reviews their processes for seeking consent, to ensure records fully reflect how people have been consulted in relation to their care”
minorIncident learning — “Accidents and incidents were documented inconsistently. Some incidents had been logged onto an incident form... Other incidents had been logged onto communication sheets”
minorEnd-of-life care — “training records identified four care workers had not received end of life care training, including one recent new starter.”
Strengths
· Consistent continuity of care from regular staff who arrived on time and stayed the required length
· Person-centred care with detailed knowledge of people's likes, preferred routines and cultural needs
· Kind and caring staff who built trusting relationships with people and families
· Strong emphasis on supporting people's independence, including requesting additional funding for care time
· Responsive communication with families and prompt response to medical emergencies
Quality-Statement breakdown (23)
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Using medicines safelyNot rated
safe: Preventing and controlling infectionNot rated
safe: Staffing and recruitmentNot rated
safe: Learning lessons when things go wrongNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Staff working with other agencies to provide consistent, effective, timely careNot rated
caring: Ensuring people are well treated and supported; respecting equality and diversityNot rated
caring: Supporting people to express their views and be involved in making decisions about their careNot rated
caring: Respecting and promoting people's privacy, dignity and independenceNot rated
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesNot rated
responsive: Meeting people's communication needsNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: End of life care and supportNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirements; Continuous learning and improving careNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: How the provider understands and acts on the duty of candourNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated
well-led: Working in partnership with othersNot rated