Angels Care At Home Ltd

This assessment was carried out to follow up on the previous rating of requires improvementand to review breaches of regulation identified at the last inspection.

At the time of the inspection the provider was supporting 2 people with a learning disability and autistic people. We have 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. We asked the service to apply for the additional service user bands of learning disabilities and autistic people as a requirement of their registration with Care Quality Commission (CQC).

The provider had not yet fully implemented effective governance systems, and we continued to identify some shortfalls. For example, some care plans and risk assessments contained incomplete, inconsistent, or missing information. This meant staff did not always have clear and accurate guidance to support the delivery of safe and consistent care.

Mental Capacity Assessments (MCAs), required under the Mental Capacity Act (MCA) 2005, were not consistently completed for people who may lack capacity. This meant the provider could not demonstrate decisions about people’s care were always made lawfully or in their best interests.

Incidents were not always fully documented or investigated to establish causes and support learning and improvement. People also continued to experience visits outside of scheduled times, in some cases up to an hour early or late. This meant people did not always receive care at the times they expected or required.

Although these concerns were identified, there was no evidence to indicate that people had come to any harm.

However, improvements had been made since the last assessment. A new registered manager was in post and had begun to drive positive changes in the service. Staff told us they felt supported, were able to contact leaders when needed, and received timely responses. Policies previously identified as incomplete had been reviewed and updated. Partners now provided positive feedback about the improvement in communication with the service.

The service had made some improvements and were no longer in breach of safe care and treatment, fit and proper persons employed and staffing.

We identified two breaches of the legal requirement in relation to need for consent and governance.

We have asked the provider for an action plan in response to the concerns found at this assessment.