Agincare UK Andover provides personal care and support to people in their own homes. The Care Quality Commission (CQC) only inspects the service being received by people provided with 'personal care', that 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 agency was providing a service for 36 older people with a variety of care needs, including people living with physical frailty or memory loss due to the progression of age.

A registered manager was not in post at the time of our inspection. 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 new manager had started with the service and will be applying to register with the commission.

People’s Medication Administration Records (MARs) were not always recorded appropriately and not all staff had been assessed as competent to administer medicines.

People felt staffing levels were not always consistent and timings could be improved especially at the weekend. Recruitment checks were safe.

People using the service and their relatives told us they felt safe. Staff understood and followed guidance to enable them to recognise and address any safeguarding concerns about people.

Most staff received regular support and one to one sessions or supervision to discuss areas of development. However, direct observations and supervisions had fallen behind for some staff. Staff completed a range of training and felt it supported them in their job role. New staff completed an induction before being permitted to work unsupervised.

People’s safety was promoted because risks that may cause them harm had been identified and were managed appropriately. There were plans in place for foreseeable emergencies. Staff contacted healthcare professionals promptly when they had concerns about people’s health and wellbeing.

Staff were able to identify and discuss the importance of maintaining people’s respect and privacy at all times. People were encouraged and supported by staff to make choices about their care.

People knew how to complain and told us they would do so if required. People and relatives were encouraged to provide feedback on the quality of the service during regular telephone quality assurance checks.

Care plans provided comprehensive information about how people wished to receive care and support. This helped ensure people received personalised care in a way that met their individual needs. People were supported with their nutritional needs when required. Staff were aware of people’s likes and dislikes.

Staff felt supported by the management and felt they could visit the office and be listened to. Regular audits of the service were carried out to assess and monitor the quality of the service.

This inspection was announced and took place on 14, 15 and 16 June 2016. At the last inspection on 20, 22 and 28 October 2015, we found that the provider had breached seven regulations associated with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (HSCA 2014).

We told the provider they needed to take action and we received a report setting out the action they would take to meet the regulations. At this inspection we found that improvements had been made with regard to each of the breaches identified. However more time was needed to ensure that the processes put in place to support the safe record keeping of medicines were effective and sustainable.

Agincare UK Andover (Agincare) is a domiciliary care agency which provides personal care and support to people who live in their own homes in Andover and the immediate surrounding areas. Agincare also offer additional services such as ‘Take a break’, which allows people’s family and full time care staff a short period of rest, as well as companionship services such as assisting with shopping. This inspection focused on the provision of personal care and did not review the ‘take a break’ and companionship services as these are not activities which are regulated by the Care Quality Commission (CQC).

People who received this service included those living with dementia, people with medical conditions such as multiple sclerosis and those suffering physical impairments due to their medical condition. At the time of the inspection Agincare was providing a range of support services to 76 people of which 50 people were receiving personal care.

Agincare had a registered manager in place. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the HSCA 2014 and associated Regulations about how the service is run. The registered manager had joined the service at the end of February 2016 and had taken positive steps to improve the quality of the service provided.

People’s Medication Administration Records (MARs) had not always been completed fully. As a result it could not always be easily identified whether people had received their medicines at the correct time and as prescribed. The registered manager was aware of the incorrect completion of the MARs and had taken appropriate steps to address this concern and we could see that improvements had been made.

People were protected from unsafe administration of their medicines because staff were trained effectively. Staff had completed mandatory training to ensure they could prompt people to take their medicines where required and where they administered people’s medicines this was carried out safely. Staff skills in medicines administration were reviewed on an annual basis by trained senior members of staff to ensure they remained competent.

People using the service and their relatives told us they felt safe. Staff understood and followed guidance to enable them to recognise and address any safeguarding concerns about people.

People’s safety was promoted because risks that may cause them harm in their own home had been identified and were managed appropriately. People were supported by staff who encouraged them to remain independent. Appropriate risk assessments were in place to keep people safe.

Thorough recruitment procedures were completed to ensure people were protected from the employment of unsuitable staff. Induction training for new staff was followed by a period of time working with experienced colleagues. This ensured staff had the skills and confidence required to support people safely. There was sufficient staff employed to ensure that people’s individual needs were met.

Contingency plans were in place to ensure the safe delivery of care in the event of adverse situations which could affect service delivery and to protec

This inspection was announced and took place on the 20, 22 and 28 October 2015.

Agincare UK Andover is an domiciliary care agency which provides personal care and support to people who live in their own homes in Andover and the immediate surrounding areas. People who receive this service include those living with dementia, people with medical conditions including diabetes and those suffering physical impairments due to their medical conditions. At the time of the inspection they were providing personal care to 73 people.

Agincare UK Andover has 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 a have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they had not always felt safe. The provider had not ensured that people were safe because they had not always provided care and support in accordance with people’s individual care plans. People who required two care staff to support them with their personal care needs had on occasion’s just one member of care staff to support them, resulting in staff requesting assistance from the person’s relative. This placed people at risk of physical harm.

People’s safety was not always promoted as although risks that may cause them harm in their home had been identified they had not always been managed. There were not always personalised risk assessments in people’s care plans detailing actions that needed to be taken to ensure a person’s safety when their care was being delivered.

There were insufficient staffing levels to ensure people’s needs were being met safely. The provider did not have a system in place to ensure the continuous assessment of staffing levels to ensure they continued to meet people’s needs. People had raised concerns with the agency due to repeated missed and late calls. When additional care staff were required the provider did not always seek assistance to ensure there were always sufficient care staff to meet people’s needs safely.

People were not always protected from the employment of unsuitable care staff. Recruitment procedures were not always fully completed. The provider had not ensured that a full employment history had been obtained from care staff before they started working for the agency. This is required to make sure that care staff can explain any gaps in their employment to ensure their suitability to work with people.

People were at risk of receiving medicines in a way they were not prescribed. People’s medication administration records (MAR) and cream application charts were not always completed correctly so it could not be established whether people had received the medicines required to maintain their health.

People were supported by care staff to make their own decisions. Care staff were knowledgeable about the requirements of the Mental Capacity Act (MCA 2005). The service worked with people and relatives when required to assess people’s capacity to make specific decisions for themselves. Care staff sought people’s consent before delivering care and support.

People’s health needs were met as care staff and the office staff promptly engaged with other healthcare agencies and professionals to ensure people’s identified health care needs were met and to maintain people’s safety and welfare.

People were not supported to have their assessed needs met by staff with the necessary skills and knowledge. People were sometimes mobilised without the equipment being used in the correct way.

Care staff demonstrated they knew and understood the needs of the people they were supporting. All the people we spoke with said they felt they had a positive relationship with their regular member of care staff. Care staff were able to identify and discuss the importance of maintaining people’s respect and privacy at all times.

People had care plans which had not always been personalised to their needs and wishes. People told us that they did not feel that they were involved in the planning of their care. Where people’s care plans had been completed fully they contained detailed information to assist care staff to provide care in a manner that respected each person’s individual requirements.

People did not always feel their complaints had been acknowledged. The provider had not always ensured that processes were in place to ensure people’s complaints were acknowledged investigated, responded to and lessons learnt to avoid a repeat incident. People repeatedly had missed or late calls even after raising concerns with the previous management at the agency.

The provider’s vision and values for the service were not known or understood by the care staff and therefore could not be delivered to people using the services.

Quality assurance processes were in place however had not always been used regularly or effectively to gather, capture and then respond to issues identified. People told us they were not able to ensure their concerns were addressed when liaising with management.

We found there to be a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.