Archived: Apex Prime Care - Newbury

Apex Prime Care – Reading is a domiciliary care agency that provides personal care to people in their own homes. It provides a service to people who have dementia, learning disabilities or autistic spectrum disorder, mental health, physical disability, sensory impairment, as well as older people.

Not everyone who used the service received personal care. 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. At the time of our inspection the service was providing personal care to 84 people.

People’s experience of using this service and what we found

People were protected from the risks of abuse and said they felt safe with the staff providing their support and care. The registered manager had the knowledge to identify safeguarding concerns and acted on these appropriately. Risks to people’s personal safety had been assessed and plans were in place to minimise those risks. Staff recruitment and staffing levels supported people to stay safe while living as independent a life as possible. Where possible, the registered manager scheduled visits so the same staff went to see people to maintain continuity of care and support. People were informed about the changes to their visits as necessary. Medicines were handled correctly and safely.

People received effective care and support from staff who knew them well and were well trained. The staff monitored people's health and wellbeing and took appropriate action when required to address concerns. People's rights to make their own decisions were protected. 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 and systems in the service supported this practice.

People were treated with care, respect, kindness and their dignity were upheld. This was confirmed by people and their relatives who provided feedback. People were consulted about their care and support and could change how things were done if they wanted to. People's diverse needs were identified and met and their right to confidentiality was protected.

People received care and support that was personalised to meet their individual needs. The registered manager and staff worked well together for the benefit of people and were focused on the needs of the people using the service.

People benefitted from staff who were happy in their work and felt well managed and supported. The registered manager encouraged feedback from people and families, which they used to make improvements to the service and protected people against the risks of receiving unsafe and inappropriate care and treatment.

The registered manager had quality assurance systems in place to monitor the running of the service, the quality of the service being delivered and took actions promptly to address any issues. The registered manager praised the staff team for their hard work and appreciated their contribution to ensure people received the best care and support.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 17 September 2018).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Apex Prime Care – Reading is a domiciliary care agency that provides personal care to people in their own homes. It provides a service to people who have dementia, learning disabilities or autistic spectrum disorder, mental health, physical disability, sensory impairment, as well as older people.

The Care Quality Commission (CQC) only inspects the service being received by people provided with the regulated activity ‘personal care’; help with tasks related to personal hygiene and eating. Not everyone using the service receives the regulated activity. Where they do we also take into account any wider social care provided. At the time of our inspection the service was providing personal care to 60 people.

The service had a registered manager in place. 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. The registered manager assisted us during the inspection. This was the first inspection of this service.

The provider had recruitment procedures that they followed before new staff were employed to work with people. They checked to ensure staff were of good character and suitable for their role. However, they did not gather all the necessary information for recruitment of staff according to regulation. They did not seek all the missing information after the inspection. They provided us with a plan of improvement gathering information for future applicants after the inspection.

Staff training records indicated which training was considered mandatory. The registered manager and senior staff had planned and booked training when necessary to ensure all staff had the appropriate knowledge to support people. However, not all staff agreed training was sufficient and informative to ensure people were supported in the right way. Staff did not always have ongoing support via supervisions. Some of the staff did not always feel supported by the management team that could help maintain a better team work. We made a recommendation about the current best practice guidance for ongoing training, monitoring and continuous support for social care staff.

The registered manager had quality assurance systems put in place to monitor the running of the service and the quality of the service being delivered. The registered manager could identify some issues and improvements necessary and they took actions to address these. However, they did not always ensure all tasks were completed as part of the management of the service such as robust recruitment process and submitting notifications on time. The quality assurance system did not always provide an accurate overview of the service.

The registered manager praised the staff team for their hard work and appreciated their contribution to ensure people received the best care and support. However, some staff felt sometimes the registered manager and senior could be more supportive and approachable. They felt communication was not always good, but the staff members worked together and supported each other, which benefited the people. Some of the staff felt there was a lack of team meetings and updates sent to them which could contribute to building a better team.

Occasionally the service had to use agency staff to cover absences. We received feedback about the agency staff, their support and timings from people and relatives that could be improved. All the information was passed to the registered manager and they addressed it with the manager of the agency. However, people and relatives were complimentary of the regular staff and the support and care they provided.

People felt safe while supported by the staff. Relatives agreed the staff supported their family members appropriately and made them feel reassured. Staff had a good understanding of how to keep people safe and their responsibilities for reporting accidents, incidents or concerns.

People were supported by sufficient numbers of staff to meet their individual needs. Where possible, the management team scheduled visits so the same staff went to see people to maintain continuity of care and support. People were informed about the changes to their visits as necessary.

People were treated with respect, and staff promoted their privacy and dignity. People and relatives felt the staff supported them in the way they wanted. Staff were responsive to the needs of the people and enabled them to improve and maintain their independence with personal care. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People received support that was individualised to their specific needs and were kept under review and amended as changes occurred. People's rights to make their own decisions, where possible, were protected and respected. Staff were aware of their responsibilities to ensure people's rights were promoted.

The staff monitored people's health and wellbeing and took appropriate action as required to address concerns. People and relatives felt confident they would be looked after well. The service assessed risks to people's personal safety, as well as staff, and plans were in place to minimise those risks. We discussed with the registered manager certain risk assessments such as moving and handling to ensure they were person specific keeping people safe. There were safe medicines administration systems in place which ensured that people received their medicines when required.

Further information is in the detailed findings below.