Background to this inspection
Updated
28 February 2019
The inspection: We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team: One inspector visited the provider’s office. An expert by experience made phone calls to people that use the service and their relatives following the inspection. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience had expertise in dementia and older people’s care.
Service and service type: Harrogate Care at Home is a domiciliary care service. It provides personal care to people living in their own homes. It provides a service to people living with dementia, physical disability and older people.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection: We gave the service 72 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.
Inspection site visit activity started and ended on 18 December 2018. We visited the office location to see the manager and office staff; and to review care records and policies and procedures.
What we did: Before the inspection we reviewed information we had received about the service since the last inspection. We contacted the local authority, professionals that work with the service and Healthwatch; an independent consumer group, which gathers and represents the views of the public about health and social care services.
Providers are required to send us key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
During the inspection we reviewed a range of records. This included four people’s care files, three medication records. We looked at three staff files in relation to recruitment and two staff supervision records. We reviewed records relating to the management of the service, such as quality assurance audits and various policies and procedures developed by the provider.
We spoke with the registered manager, owner of the service and two care workers.
Following the site visit we spoke with three people that use the service and five of their relatives. We received feedback from one social care professional.
Updated
28 February 2019
About the service: Harrogate Care at Home provides people with personal care needs in their own home. Some people were supported whilst their main family carer took a break from their caring role. 43 people used the service at the time of the inspection. The majority of people receiving personal care were older people, people with a physically disability or people living with dementia.
People’s experience of using this service:
People and their relatives were confident they were in ‘safe hands’. Safe staffing levels were maintained. Care visits were arranged to ensure staff had sufficient time to support them safely. Risks to people were identified in their care plans. Risk assessments were not always in place to help identify risks and guide staff in how to manage these.
We have made a recommendation about medicines best practice guidance.
People received an assessment prior to receiving support to help staff understand their needs and preferences. People signed their care plans to indicate their consent to this. Records did not always reflect that the provider had followed the Mental Capacity Act 2005 for people that may lack capacity.
Staff received training and support to assist them with understanding and carrying out their roles.
The provider promoted the values of dignity and respect. People felt these values were reflected in the care they received. Staff understood people’s preferences and how to support them effectively while promoting their independence.
People received care personalised to their needs. Staff understood their preferences and adapted people’s care depending on whether they were having a ‘good’ or ‘bad’ day.
The provider was proactive in seeking feedback from people and their relatives. Complaints were addressed promptly.
The registered manager had completed a range of checks to help maintain safety and quality across the service. They planned to review these to ensure they covered the points we identified.
People and staff were involved in the running of the service. Surveys were used to monitor the experience of people using the service. Staff attended team meetings, where they had the opportunity to make suggestions.
Staff worked with local charities to support people. They understood the role of other professionals, acting on their recommendations and seeking advice when this was needed.
More information is in the Detailed Findings section below.
Rating at last inspection: Good (report published 29 June 2016)
Why we inspected: This was a planned inspection based on the previous rating of the service.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.