9 September 2020
During an inspection looking at part of the service
Harmony Homecare Limited is a domiciliary care agency providing personal care and support to 26 people in their own houses and flats.
People’s experience of using this service and what we found
Medicines were not always managed safely. Individualised risks to people were not consistently assessed and mitigated.
The provider had not always maintained effective oversight of the safety and quality of the service. Where action plans were put in place improvements were not consistently embedded and sustained.
Improvements were required to ensure staff had access to the latest government guidance and information on protecting people and themselves from Covid-19. Staff did have access to a good supply of appropriate personal protective equipment (PPE) and described how to use it appropriately.
Staff were recruited safely and there was enough staff to meet people’s needs under usual circumstances. However, the providers contingency plan required improvements to ensure the service could remain operational under winter pressures and high levels of staff sickness.
People were not consistently supported to have maximum choice and control of their lives and staff did not consistently support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support consistently support this practice. The provider had in some cases made generic decisions in people’s best interest without consulting them on their preference.
People were invited to give feedback on their care, and we saw positive feedback. Staff enjoyed working for the provider and retention rate of staff was good.
People were safe from the risk of abuse by kind and caring staff who understood how to recognise signs of abuse and how to report it.
The provider worked in partnership with other professionals when needed and liaised with family members to provide updates on change or concerns.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was requires improvement (published 22 August 2019) and there were multiple breaches of regulation. The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.
Why we inspected
We carried out an announced comprehensive inspection of this service on 4, 6, 9 July 2019. Breaches of legal requirements were found in safe care and treatment, good governance and staffing. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe and well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Harmony Homecare Limited on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to safe care and treatment and good governance at this inspection. Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.