Date of assessment: 4 June to 25 June 2025. The service is a domiciliary care agency providing personal care to people in their own homes. At the time of the assessment there were 305 people using the service. We carried out this assessment in response to concerns raised regarding the service, specifically related to medicines administration, moving and handling practices and missed care calls. At the last inspection of this service in May 2022 we found the provider was in breach of the legal regulations in relation to safe care and treatment and good governance. During this assessment we found the provider had made significant improvements and was no longer in breach of these regulations. We spoke with over 15 members of staff including the management team and care staff. We spoke with 19 people and their relatives who use the services of Loving Angels Care (West and North Northamptonshire). Care plans were personalised and contained good quality information and instructions that enabled staff to support people safely. People were treated with kindness and compassion. Staff sought people’s consent before providing care and encouraged people to maintain their independence. People and their relatives had been involved in developing their care plans. Staff knew how to seek medical assistance in emergencies and kept people’s families informed. However, we found they were not always confident to do so, and the registered manager had addressed this. Staff completed inductions, relevant training and competency checks were carried out. The service had systems and process in place to monitor aspects of the service. However, we identified some issues which the registered manager was responsive to and made changes accordingly. The service had two registered managers, and one nominated individual all were responsive during the assessment.
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Loving Angels Care (Northampton) was rated Requires Improvement overall, with breaches of Regulation 12 (Safe Care and Treatment) and Regulation 17 (Good Governance) identified due to medicine record failings, inadequate risk assessments and ineffective oversight. People felt safe and described staff as kind and caring, but care planning, training evidence, visit duration and governance systems all required improvement.
Concerns (10)
criticalMedication management: “People's medicine administration records (MAR) were not always clear regarding whether a medicine had been administered.”
criticalMedication management: “Staff had regularly used the wrong code on MAR to record if a person had refused their prescribed medicine.”
criticalCare planning: “Risk assessments were not always in place or did not always contain the relevant strategies to ensure staff understood how to mitigate the risks identified.”
criticalGovernance: “The provider had failed to ensure adequate systems and processes were in place to assess, monitor and improve the quality and safety of the care provided.”
moderateCare planning: “Not all care plans contained detailed information. We found information was lacking regarding people's health or mental health needs.”
moderateMissed or late visits: “Records evidenced staff were not always staying with people for the allocated time and we received mixed views from people and relatives regarding staff time keeping.”
moderateStaff training: “we found no evidence of staff receiving training in mental health, epilepsy or diabetes and people required support with these needs.”
moderateRecord keeping: “Records of people's injuries did not always contain the size, shape or colour of the injury.”
moderatePerson-centred care: “We found two records for a person that described them using language which was not respectful or person centered.”
minorCultural competency: “specific information when a person did not speak English had not been recorded. For example, key phases or words in the person's native language”
Strengths
· People felt safe with staff and described them as kind, caring and respectful
· Staff were safely recruited with DBS checks and references
· Staff used PPE effectively and followed COVID-19 government guidance
· Staff received safeguarding training and understood how to raise concerns
· People were supported to access healthcare professionals such as occupational therapists and speech and language therapists
Quality-Statement breakdown (20)
safe: Using medicines safely; Assessing risk, safety monitoring and managementRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Staffing and recruitmentNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawRequires improvement
effective: Staff support: induction, training, skills and experienceNot rated
effective: Staff working with other agencies; supporting people to live healthier lives, access healthcareNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
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 careNot rated
caring: Respecting and promoting people's privacy, dignity and independenceNot rated
responsive: Meeting people's communication needsGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: End of life care and supportNot rated
well-led: Promoting a positive culture; managers and staff understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Duty of candourNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated
well-led: Continuous learning and improving care; working in partnership with othersNot rated