Angels Care Agency Limited

CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

We found management systems were not fully effective in monitoring the quality and safety of the service. The service undertook regular quality assurance questionnaires, and results returned from people and families indicated a high level of satisfaction with the service. We found other governance systems in place, such as a monthly compliance audit, had not been fully effective in monitoring the service. For example, audits had failed to identify all of the concerns we found in relation to risk assessments and medicine records.

We have made a recommendation in relation to systems in place to evidence staff had demonstrated the knowledge and skills to perform their roles. The service kept records of staff training, shadowing and supervisions and the registered manager was confident staff were working safely and effectively. People and relatives also felt staff had the required training to support them. One person's representative explained, "From a user perspective the staff are trained. They have a consistent approach. Files and paperwork are always up to date. Any concerns and they will contact us. Communication is excellent."

People and relatives felt the service was safe, and people benefited from consistent continuity within staff rotas. People told us staff arrived on time and stayed the required length of time to support them. People received person-centred care from staff who understood their needs. Staff could speak in detail about people they support, with knowledge of people's likes, preferred routines and what was important to people. One person advised, "I have the same carers. I need consistency or care doesn't work. [Staff member] has gone above and beyond – absolutely amazing."

People's needs were assessed, and care plans provided an overview of people's physical, social and emotional needs. Where appropriate, people were supported by family members or an advocate as part of care assessments to make decisions about their care and support. A relative commented, "We were involved

in the assessment. [Person's name] can make some decisions. We try to involve him where possible."

People were supported by staff who were kind and caring. A relative advised, "The carers are very lovely people, I can tell by the way they treat [relative]. [Staff member] is very lovely, the way she talks to her and the way she treats her. [Relative] will often ask for her." A person using the service added, "Carers are lovely people. Always willing to help and will tackle anything I ask them to do for me."

The service placed an emphasis on supporting people's independence and where necessary had requested additional funding for people's care to enable staff to have sufficient time to support people. This meant people could try to achieve day to day tasks more independently without feeling rushed. A person who was supported to self-medicate explained staff only helped with tasks they could not do themselves, such as loosening the lids on medicine bottles. A relative also commented, "Carers take their time to shower [relative]. He is not rushed."

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies in the service supported this practice. We recommended 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, to ensure the service meets legal requirements and follows relevant best practice guidance.