Availl (Cambridge) is a domiciliary care agency. It provides personal care to adults living in their own houses and flats.

Not everyone using Availl (Cambridge) received the regulated activity of personal care. 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.

This announced inspection took place from 19 December 2018 to 3 January 2019. At the time of this inspection, 26 people received the regulated activity, personal care.

At our last inspection on 20 January 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a 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.

People were protected from avoidable harm by a staff team who were trained and confident to recognise and report any concerns. Staff assessed and minimised potential risks. The provider only employed staff after they had obtained satisfactory pre-employment checks. There were enough staff to ensure people’s needs were met safely and in a timely manner.

People were supported to manage their prescribed medicines by staff who were trained and had been assessed as competent to administer medicines. Staff followed the provider’s procedures to prevent the spread of infection and reduce the risk of cross contamination.

People’s care was planned and delivered in line with good practice guidance. Staff knew the people they cared for well and understood, and met, their needs. People received care from staff who were trained, well supported, and had the skills and knowledge to meet people’s assessed needs.

Staff supported people to have enough to eat and drink. People were assisted to have access to healthcare services to help maintain their health and well-being.

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 fully involved in making decisions about their care and support. People and their relatives were involved in the setting up and review of their or their family member’s individual support and care plans.

Staff treated people kindly and made people feel that they mattered. Staff respected and promoted people’s privacy, dignity and independence.

Staff met people’s personal and health care needs. Care records provided staff with guidance on how to do this. Staff supported people to consider their end of life care to ensure they had the most comfortable, dignified, and pain-free a death as possible. Staff worked in partnership with other professionals to ensure that people received the best care possible.

People’s suggestions and complaints were listened to, investigated, and acted upon to help improve the service.

Staff liked working for, and were well supported by, the registered manager. The registered manager sought feedback about the quality of the service provided from people and acted to make improvements.

The provider’s monitoring process looked at systems throughout the service. The registered manager also carried out audits and quality monitoring checks to help identify shortfalls and to help drive forward improvements.

Further information is in the detailed findings below.

Availl (Cambridge) is registered to provide personal care to people living in their own homes. During this inspection personal care was being provided to 32 people in their own homes.

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.

This announced comprehensive inspection was undertaken on 20 January 2016.

Staff were only employed after the provider carried out satisfactory pre-employment checks. Staff were trained and well supported by their managers. There were sufficient numbers of staff to meet people’s assessed needs.

Systems were in place to ensure people’s safety was effectively managed. Staff were aware of the procedures for reporting concerns and took action to reduce the risk of people experiencing harm.

People’s health and personal needs were effectively met. Systems were in place to safely support people with the management of their medicines. People received their prescribed medicines appropriately.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. People’s rights to make decisions about their care were respected. Staff were acting in accordance with the Mental Capacity Act 2005 so that people’s rights were being promoted.

People received care and support from staff who were kind, caring and respectful. Staff respected people’s privacy and dignity and offered reassurance when people needed it.

People were encouraged to provide feedback on the service in various ways both formally and informally to ensure they were receiving the care and support they required. People, and their relatives, were involved in their care assessments and reviews. Care records were detailed and provided staff with guidance to enable them to provide consistent care that met each person’s needs. Changes to people’s care was kept under review to ensure the change was effective.

The provider had quality assurance processes and procedures in place to monitor the quality and safety of people’s care. People felt listened to and the registered manager used their feedback, together with audits of the service to drive improvement. People told us that all staff including the registered manager were approachable.

People that we spoke with were positive about the care and support they received from care staff and commented that: “The carers are cheerful and help me with what I need.” People told us that they received care and support in a respectful and dignified manner.

We saw evidence of peoples’ preferences in the way they wanted their care to be provided and planned. Care and support was appropriately assessed and each care visit was documented with guidelines for staff for the care and support the person required.

Records showed staff were trained and monitored regarding the administration of medication. Staff told us they were aware of their responsibilities when recording medication that they had given or prompted people to take.

There were training programmes and regular supervision sessions in place to ensure that care staff remained competent to deliver care and support to people using the service.

The agency had effective procedures in place to regularly assess and monitor the quality of the service that was provided to people.

People we spoke with were positive about the care and support they received and commented that, “Its great and I am very happy with my carers” and, “The carers are kind and gentle with me”. People told us that they felt involved in their care and support and that their views and concerns were listened to and properly dealt with.

Care and support was well coordinated and detailed assessments were completed prior to the care package commencing. However. we noted that care records did not always include enough detail and guidance for staff regarding the care that was to be provided. The manager told us that they would review how care plans were being written and implement clearer guidelines for staff. There was evidence in care plans of people’s agreement and involvement in reviews of their care and support.

Staff were trained in safeguarding people from harm. Information regarding how to contact the local authority safeguarding team had been made readily available to staff and people using the agency.

The agency had an effective system to regularly assess and monitor the quality of the service and to ensure that people’s concerns or issues were appropriately dealt with.

People spoken with and their relatives met during the visit were positive about the care and support that is provided. People felt involved in decisions being made about their lives and there was a good rapport observed with staff. People felt that their choices and independence was promoted as much as possible and that they were involved in the care planning process.

Evidence was seen of regular reviews in care plans and participation is promoted by the service. People stated that they received good quality and professional support from carers and were in regular contact with managers of the service and knew who to speak to if they wished to raise any concerns.