APC Care Limited

Updated 6 November 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We previously inspected the service in December 2016 at which time we rated the provider as ‘Good’ in all five key question areas. In line with our methodology we would not be required to inspect the service again until a period of 30 months had passed. However, at the time of the last inspection this provider was part of a franchise organisation. We had received concerns from the franchise organisation regarding the provider and the franchise contract was terminated. We require registered providers to have a registered manager. This provider had not had a registered manager in post since 2016. We inspected the service sooner than we were required to do so to seek assurances of the quality and safety of the service people received.

This inspection took place on 26 and 28 September 2018 and was announced.

We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

Inspection site visit activity started on 26 September 2018 and ended on 28 September 2018. It included shadowing care staff when they visited people in their homes. We visited the office location on 28 September 2018 to see the care manager and office staff; and to review care records and policies and procedures.

The inspection was conducted by one inspector and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Due to technical problems, the provider was not able to complete a Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We spoke with seven people and two of their relatives. We also observed staff practice of two care staff with three people in their homes. We reviewed the care records for three people. Three staff records were reviewed which included, staff supervisions, ‘spot checks’ and training records. Organisational policies and procedures and systems for monitoring the quality and safety of the service were also viewed.

We spoke with the registered provider, the care manager, assistant care manager and three care staff. We also received information about the service provided from the East Sussex County Council social services brokerage manager and market support manager who commission services with the provider.

Updated 6 November 2018

This inspection took place on the 26 and 28 September 2018 and was announced.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults, people who may be living with dementia and younger adults. At the time of this inspection the agency provided personal care to 16 people.

Not everyone using APC Care Limited receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

At the time of this inspection there was no registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. A manager had recently joined the agency and had applied to us to become the registered manager for the agency. We had received their application to register with us.

We did not find any breaches of regulations at this inspection but have rated the ‘Well-led’ key question as ‘Requires improvement’ due to the historic and current lack of continuity in the management of the service which had resulted in some people experiencing an inconsistent service.

People were safeguarded by a staff team with awareness and understanding of how to report concerns of abuse to appropriate professionals. People were given medicines safely and records were held of the care provided to people. The provider engaged with healthcare professionals as appropriate.

People were involved in the planning of their care and independence was promoted where possible. Consent was sought from people before services were provided to them. Risks to people were assessed and action taken to mitigate risk. The risks of infection were reduced with infection control measures which included the appropriate use of protective equipment such as gloves and aprons. There were enough staff to provide support to people. The care manager was recruiting additional staff to ensure that people received a consistent service from regular staff.

Care staff received training and support from the management team to support them in their roles. Care staff were observed to provide care safely and appropriately to people. Privacy and dignity was maintained by caring and dedicated staff.

People and care staff views were sought regarding the service provided and people were confident to use the complaints process when this may be required. Complaints were investigated and responded to appropriately.

Improvements had been made to the quality and safety of the service following the termination of the former franchise contract.