About the service:

Aaron Abbey Care Services Limited is a domiciliary care agency. It provides a service to people living in their own homes in Berkshire. Not everyone using the service receives a regulated activity. The Care Quality Commission only inspects the service being received by people provided with 'personal care', that means help with tasks related to personal hygiene and eating. At the time of this inspection staff were providing personal care to 28 older people and/or younger adults, some of whom may be living with dementia, physical disabilities and/or sensory impairments.

People’s experience of using this service:

¿The provider had not taken enough action to ensure the safe and proper management of medicines. They had not established an effective system that enabled them to ensure compliance with the requirements of the fundamental standards.

¿Where possible, the registered manager scheduled visits so the same staff went to see people to maintain continuity of care and support. However, the registered manager did not have an effective system to monitor late/early or missed visits at all times.

¿We have made a recommendation about seeking guidance from a reputable source to ensure principles of the Accessible Information Standard are met.

¿At the last inspection we found the registered manager had not ensured staff received appropriate support, training and supervision to carry out the duties they are employed to perform. At this inspection we found the provider had taken the necessary action to improve staff support and training.

¿People felt safe while supported by the staff team who made them feel reassured and relatives agreed with this.

¿Staff had a good understanding of how to keep people safe and their responsibilities for reporting accidents, incidents or concerns.

¿The registered manager had the knowledge to identify safeguarding concerns and acted on these appropriately.

¿The registered manager and senior staff had planned and booked training when necessary to ensure all staff had the appropriate knowledge and skills to support people. Staff had ongoing support, supervision and appraisals. They felt supported by the registered manager and senior staff, and maintained good team work.

¿People and relatives were complimentary of the staff and the support and care they provided. People received support that was individualised to their specific needs which were kept under review and amended as changes occurred. 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 were treated with respect, and their privacy and dignity were promoted. People 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.

¿The staff monitored people's health and wellbeing and took appropriate action when required to address concerns. People felt confident they would be looked after well and relatives agreed with them.

¿The service assessed risks to people's personal safety, as well as staff, and plans were in place to minimise those risks.

¿The service had recruitment procedure that they followed before new staff were employed to work with people. This included ensuring staff were of good character and suitable for their role.

¿Staff felt the registered manager and senior staff were approachable and considerate. They had good communication, worked well together and supported each other.

¿The registered manager praised the staff team for their hard work and appreciated their contribution to ensure people received the best care and support.

Rating at last inspection: The service was rated Good in the domains of caring and responsive. The service was rated Requires Improvement in the domains of safe, effective and well-led. We found three breaches. Overall

This inspection took place on 21, 22 and 24 November 2017. We gave the provider 48 hours' notice because the location provides a domiciliary care service and we needed to make sure someone would be in the office.

Aaron Abbey Care Services Limited is a domiciliary care agency. It provides a service to people living in their own homes in Berkshire. Not everyone using the service receives a regulated activity. The Care Quality Commission only inspects the service being received by people provided with ‘personal care', that means help with tasks related to personal hygiene and eating. At the time of this inspection staff were providing personal care to 31 older people and/or younger adults, some of whom may be living with dementia, physical disabilities and/or sensory impairments.

At the last inspection on 25 and 26 October 2016 we found breaches of three regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider had not carried out all required recruitment checks to make sure staff were suitable to work with people who use the service. The provider had not ensured the safe and proper management of medicines. The provider had not established an effective system that enabled them to ensure compliance with the requirements of the fundamental standards (regulations 8 to 20A of the regulations). We asked the provider to complete an action plan to show what they would do, and by when, to improve the key questions Safe and Well-led. They sent an action plan which stated that all actions would be completed by 31 January 2017.

At this inspection we found the provider had taken the necessary action to improve staff recruitment. However, the provider had not taken enough action to ensure the safe and proper management of medicines and had not established an effective system that enabled them to ensure compliance with the requirements of the fundamental standards.

We found an additional breach of the regulations, the provider had not provided staff with the appropriate training and support needed to enable them to carry out the duties they were employed to perform.

The service had a registered manager as required. 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 is also the nominated individual and one of the two directors of the provider organisation. The care manager is the second of the two directors. The registered manager and care manager were present and assisted us during this inspection.

People felt they were treated with care and kindness. They were consulted about their support and could change how things were done if they wanted to. People were treated with respect and their dignity was upheld. This was confirmed by people and relatives who provided feedback.

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 were asked for their consent before being provided with care and their preferences were sought and taken into account in their care plans. However, the service needed to ensure they obtain consent from people before sharing information regarding their personal care with their relatives.

People's diversity needs were identified and incorporated into their care plan. Where their package included support with food and drink, people were supported to eat and drink enough.

Staff were happy working for the service and people benefitted from staff who felt well managed and supported. Personal and environmental risks to the safety of people and staff had been assessed and actions had been taken to minimise those risk

This inspection took place on 25 and 26 October 2016. We gave the provider 48 hours' notice because the location provides a domiciliary care service and we needed to make sure someone would be in the office. This was the first inspection of the service at this location.

Aaron Abbey Care Services Limited provides a service to people living in their own homes in Berkshire. At the time of this inspection they were providing a service to 30 people.

The service has a registered manager as required. 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 was present and assisted us during this inspection.

Staff were available in enough numbers to meet the needs and wishes of the people they supported. Staff felt they received the training they needed to enable them to do their jobs safely and to a good standard. People were protected from abuse and staff had a good understanding of action they should take if any concerns were raised or suspected.

People's health and well-being was assessed and care plans were designed to ensure people's needs were met in an individualised way. Where included in their care package, people were supported to eat and drink enough.

People received support that was individualised to their specific needs. Their needs were monitored and care plans reviewed and amended as changes occurred. People's rights to make their own decisions, where possible, were protected and staff were aware of their responsibilities to ensure people's rights to make their own decisions were promoted. People confirmed they were involved in decision-making about their care and support needs.

People were treated with respect and their privacy and dignity was promoted. People said their care workers were kind and caring. Staff were responsive to the needs of the people they supported and enabled them to improve and maintain their independence. Professionals said the care and support provided by the service helped people to be as independent as possible.

People benefitted from receiving a service from staff who worked well together and felt management worked with them as a team. Quality assurance systems were in place to monitor the views of people using the service.

We found breaches of three regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider had not carried completed all required recruitment checks to make sure staff were suitable to work with people who use the service. The provider had not ensured the safe and proper management of medicines by carrying out staff competency assessments before allowing staff to administer medicines. The provider had not established an effective system that enabled them to ensure compliance with the requirements of the fundamental standards (regulations 8 to 20A of the regulations), or their own policies. The provider had not maintained an accurate, complete and contemporaneous record of decisions taken in relation to the care and treatment provided to each person. You can see what action we told the provider to take at the back of the full version of the report.

This inspection took place on 13 and 15 May 2015 and was announced. We gave the registered manager 48 hours' notice as it is a small service and we needed to make sure someone would be in the office. At the last inspection on 14 and 15 July 2014 we asked the registered person to take action to make improvements to: the care and welfare of people; staff recruitment; supporting staff and assessing and monitoring the quality of the service. We found the registered person had taken some action to meet the requirements of the regulations. However, the work started needed to be completed.

Aaron Abbey Care Services Limited provides a service to people living in their own homes in Berkshire. At the time of this inspection they were providing a service to 38 people.

The service has a registered manager as required. 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.

Staff were available in enough numbers to meet the needs and wishes of the people they supported. People were protected from abuse and staff had a good understanding of action they should take if any concerns were raised or suspected.

People were treated with respect and their privacy and dignity was promoted. Staff were caring and responsive to the needs of the people they supported. Staff sought people's consent before working with them and supported their independence.

People told us they got the care and support they needed, when they needed it. People's health and well-being was assessed and measures put in place to ensure people's needs were met. Where included in their care package, people were supported to eat and drink enough.

People benefitted from a service that had an open and friendly culture. Staff were happy working for the service and told us they got on well together and felt well supported by their managers.

We found breaches of five regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider had not carried out all required recruitment checks to make sure staff were suitable to work with people who use the service. Staff were not provided with appropriate induction, training, supervision and appraisal. Care was not always provided in a safe way and the provider had not ensured the safe and proper management of medicines. Care was not designed in a way that reflected people's preferences. The provider had not established an effective system that enabled them to assess, monitor and improve the quality and safety of the service provided. You can see what action we told the provider to take at the back of the full version of the report.