The Essex home care service has been told it needs to improve after an inspection revealed failings in its leadership and ensuring the safety of its patients.

Annie's Homecare Services Ltd, based in Mayland, is a personal care provider for people living in their own homes. The company's NHS web page states its specialisms as being caring for those with dementia and adults aged over 65, care services for those with eating disorders, mental health conditions, physical disabilities and sensory impairments.

The Care Quality Commission (CQC) conducted an inspection of the service throughout October this year following concerns being raised over a lack of oversight of care being given and received and the effectiveness of individual risk assessments.

In the report's introductory summary, inspectors said that "risks to people's safety were not assessed or managed appropriately", "people did not always receive personalised care which reflected their individual needs and preferences", and that "people's care plans and risk assessment documentation was poorly completed and end of life care needs and wishes had not always been considered". 

Annie's Homecare Services Ltd has been rated as 'requires improvement" since November 2022, with its 'well-led' rating being demoted to 'inadequate' during the latest inspection.

When assessing the safety of the service, inspectors concluded that there was "limited assurance about safety and an increased risk that people could be harmed".

A number of service users were receiving catheter care, but risk assessments relating to this were found to be inadequate or were not always in place. There was also a lack of proper guidance in place for people suffering with epilepsy, Parkinson's diagnoses, mental health support needs and eating and drinking risks, which placed them in danger of receiving unsafe care.

Evaluating the service's responsiveness, the report reads: "The provider did not always empower people to have choice and control over the timing of their care visits. People's care documentation did not always state their preferences for the timing of their visits and people told us they did not always know what time staff would arrive."

Inspectors received mixed reviews from family members, with one commenting that punctuality was sometimes an issue and that care staff's time-keeping "could be a little better". Where end-of-life care was being received or considered, service users' personal care plans had not been updated. This meant that inspectors judged the service not to be implementing "accurate guidance… about how to provide dignified and appropriate end of life support". However, the provider acted immediately to ensure end-of-life care wishes were recorded where necessary. 

When assessed on whether it was 'well-led', the service's rating changed from 'requires improvement' to 'inadequate'. In their report, inspectors said: "This meant there were significant shortfalls in service leadership,

"Leaders and the culture they created did not assure the delivery of high-quality care."

Supervision and appraisal records were "poorly completed", and it was stated that the provider did not understand its responsibility to notify CQC of safeguarding concerns along with evidence of its strategy to address these concerns. Inspectors said that the management team "had not consistently created a learning culture at the service, which meant people's care did not always improve".

The report continues: " The provider has been rated as 'requires improvement' or 'inadequate' in the 'well-led' domain for four of the last five inspections… which demonstrates a lack of sustained improvement in the service.

"A warning notice was issued at the last inspection highlighting significant concerns with the provider's governance and oversight. Whilst some actions have been taken, including recruiting a quality and compliance manager to support the implementation of their electronic call monitoring and medicines systems, significant concerns remain. 

"The provider has not made the required improvements to ensure people receive good quality, safe care."

LDRS has contacted Annie's Homecare Services Ltd for comment.