About the service:

AJB Care Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. At the time of the inspection the service employed 20 staff and was providing care to 62 people.

People’s experience of using this service:

People and relatives told us that the service was caring and support was personalised to people’s individual needs and preferences.

People told us the length and times of visits were reliable, effective and flexible.

Overall medicines were managed safely but we identified that some improvements were needed in systems and processes for auditing.

People were supported by a consistent, experienced and well-established team.

Staff were knowledgeable and received regular training and good supervision.

The registered manager provided people with leadership and was approachable.

People’s views were sought about the service and feedback was welcomed and acted upon.

The registered manager conducted some audits but these were not robust or timely.

We identified a breach of Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Rating at last inspection:

At the last inspection on 27 August 2016 the service was rated good.

Why we inspected:

This inspection was part of our routine scheduled plan of visits

Follow up:

We will continue to monitor the service to ensure that people receive safe, high quality care. Further inspections will be planned for future dates.

AJB Care Ltd is a domiciliary care agency registered to provide personal care for people living in their own homes. They are also piloting a service where they respond to people’s assistance in an emergency.

At the time of the inspection the agency was supporting approximately 75 people, equating to approximately 726¾ hours of care per week. We telephoned 18 of those people and were able to speak with 11, to obtain their views of the support provided and one relative about their experience of the support their relative received from the agency. Prior to our inspection at the office base, we visited six people in their own homes. On three of those visits, relatives were in attendance and we also spoke with them.

Also, as part of the inspection we sent out questionnaires to 33 people. Seventeen of these were returned and the responses used to inform our judgements about the service.

At the time of this inspection the service employed 31 staff. We telephoned seven of those staff and were able to speak with four of them to obtain their views and experience of working for this agency. We also spoke with two members of staff on the office visit.

We told the provider two days before our inspection that we would be visiting the service. We did this because the registered manager is sometimes out of the office and we needed to be sure that they would be available.

There was a manager at the service who was registered with CQC. 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 and associated Regulations about how the service is run.

The service was last inspected on 16 June 2014 and was meeting the requirements of the regulations we checked at this time. This is the first rated inspection of the agency.

There were sufficient staff to provide a regular team of care staff and the majority of recruitment information and documents were available for staff.

Staff had received training so that they had the right knowledge and skills they needed to carry out their role, so that people received effective care. Staff confirmed that following initial training they felt supported in their job role.

People told us they were treated with consideration and respect and that staff knew them well.

People and relatives told us when they raised any issues with staff and managers, their concerns were listened to, but information to evidence the action taken needs improving.

Staff were familiar with people’s individual needs and were able to describe how they maintained people’s privacy and dignity.

People had confidence in the service and felt safe and secure when receiving support. Staff had a good understanding of what to do if they saw or suspected abuse or if an allegation was made to them.

Staff sought people’s consent to care and treatment.

In the main, care records that had been reviewed reflected the care delivered to people and the care and support that they and their relatives described to us. Risks to the health, safety or wellbeing of people who used the service were assessed and action taken to minimise those risks.

Systems were in place to manage people’s medicines.

People were supported with their health and dietary needs, where this was part of their plan of care or in an emergency.

There were quality assurance systems in place to monitor the quality of the service provided, but these could be better to further improve the service.

At the time of this inspection, records showed there were 52 people who were supported by the service. We telephoned eight people that used the service, or their representatives to ask them about their experiences of AJB Care Ltd. We were able to speak with six people. We were also able to speak with three people who were visiting the day centre, which operates at the same location as the service.

We also telephoned five care staff employed by AJB Care Ltd to ask them about their experiences of working for the agency. We were able to speak with two staff. We also spoke with three staff in person at the agency’s office.

In addition to speaking with people who used the service and/or their representatives, staff and the registered manager, we also reviewed a range of relevant documentation.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask: Is the service safe, effective, caring, responsive and well led?

Below is a summary of what we found.

Is the service safe?

Care and treatment was planned and delivered in a way that was intended to ensure people’s safety and welfare. Care plans and risk assessments were available in people’s homes for staff to follow, so that people received the care they needed.

People who used the service told us they felt safe with the staff that provided support for them. We found systems and processes were in place to safeguard people from harm and abuse. This was because staff had received training to provide them with the knowledge to identify abuse and where to report abuse, so that appropriate action could be taken to safeguard people.

Although this was a domiciliary care agency, where the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) does not apply, the registered manager and staff were aware of policies and procedures in relation this. This meant the same principles applied, that where a person had capacity they did not intervene with any decisions they made, unless they felt the person’s capacity was deteriorating when they would report this for appropriate intervention.

In the main, we found recruitment documents were in place before staff commenced work, which meant the registered manager could be assured staff were safe to work with vulnerable people. In addition, regardless of previous training staff had completed in their previous role, before they started work they undertook all the training provided by AJB Care Ltd. This was so that the registered manager was assured they were safe to do their job, in accordance with AJB Care Ltd’s policies and procedures.

Is the service effective?

People and their families described how they were involved in the assessment and care planning of their care needs, so that they received care that met their needs and supported their rights. Staff had regular rotas that they followed to enable continuity of care and ensure they knew people well.

Is the service caring?

Comments received by people who used the service and/or their representatives told us that people were treated with respect by staff who delivered their care and support. They said their views and experiences were taken into account in the way the service was provided and delivered in relation to their care.

Is the service responsive?

The service was responsive in listening to people and staff’s concerns/complaints, but records did not always make it clear how the complaint had been investigated and the names of staff involved, so that an audit trail of the actions taken could be confirmed.

When we spoke with people who used the service, their representatives and staff the majority told us that in the main the service listened to their concerns and acted on them. One comment included, “I’ve no complaints, it’s very good. If I had I’d tell the boss. She always asks if everything’s alright, she’s very good”.

Is the service well-led?

The service had quality checking systems in place to manage risks and assure themselves of the health, safety and welfare of people who used the service and staff.

People who used the service and their representatives and staff confirmed they had regular monitoring visits to check the quality of the service and that the care provided continued to meet their needs. Comments included, “they’re always sending out rating forms. My [relative] always rates them above. She says they go above and beyond what they need to do. We’ve been with the service a number of years and it hasn’t deteriorated in all that time. We have the occasional mishap, for example, a missed call, but nothing really. We’ve no problems at all” and “I’ve just filled in a survey. You fill them in about every six months. I always rate them very high”.

Staff we spoke with also told us they felt supported by the management of the service.

If you want to see the evidence supporting our summary please read the full report.