Archived: HICA Home Care - Bradford

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

This is a summary of what we found. The summary describes the records we looked at and what people using the service, their relatives and the staff told us.

Is the service safe?

We found evidence people were not always protected against the risks associated with medicines because there were not appropriate arrangements in place to ensure medicines were managed safely. We have asked the provider to tell us how they will make improvements to meet the requirements of the law in relation to the management of medicines.

We found people were not always protected from the risks of unsafe or inappropriate care. We saw evidence the service had not always taken appropriate action to reduce risks for people. We also saw identified risks were not always supported by appropriate care plans to ensure people received safe and consistent care. We have asked the provider to tell us how they will make improvements to meet the requirements of the law in relation to the care and welfare of people who use the service.

Is the service effective?

The service had arrangements in place to ensure staff were trained and supported. This showed us people were being cared for by staff who were supported to deliver care and treatment to an appropriate standard.

We saw evidence people were not always receiving care and support at the times they required it. Seven of the eight people we spoke with said staff had been over an hour late for a call on at least one occasion in the past month. Five of these people said staff had not turned up at all for a call in the past month. We have asked the provider to tell us how they will make improvements to meet the requirements of the law in relation to the care and welfare of people who use the service.

Is the service caring?

Overall, people told us they were happy with the care and support staff provided. However, people said they did not always receive this support at the times they needed it. We found the care staff we spoke with demonstrated a good knowledge of people's needs and were able to explain how individuals preferred their care and support to be delivered.

Is the service responsive?

The provider had a process in place to deal with any complaints people made. However, we found evidence the service did not always follow this policy and deal with complaints effectively. We have asked the provider to tell us how they will make improvements to meet the requirements of the law in relation to complaints.

There was no formal system in place to ensure daily notes were regularly checked to ensure any changes in people's needs were quickly identified. From the records we reviewed we were also not always able to evidence that appropriate action had been taken when people's needs had changed. We have asked the provider to tell us how they will make improvements to meet the requirements of the law in relation to assessing and monitoring the quality of service provision.

Is the service well led?

People provided feedback that the service was not well led. One person told us 'The service manager promises things, but then doesn't deliver them. I am not confident they know what's going on'. Another person said 'If you raise an issue you never know who is going to contact you; it could be someone from Hull; it could be someone from Chorley. It's confusing because I want someone based in Bradford to speak to me so they know my relative'.

We also saw evidence there were not effective systems in place to enable management to continually monitor and identify shortfalls in the service.

We have asked the provider to tell us how they will make improvements to meet the requirements of the law in relation to assessing and monitoring the quality of service provision.

We spoke with eleven members of support staff employed by the agency and a care co-ordinator. The staff told us they always respected people's rights to privacy and dignity when they provided care and support, encouraged people to retain their independence and provided care and support in line with their agreed care plan.

We found generally the provider had enough staff to ensure the safety and welfare of people who used the service. However, some staff we spoke with told us in certain geographical areas they were under pressure and working long hours to make sure people received care and support in line with their agreed care package.

We found the agency had quality assurance monitoring systems in place which involved people who used the service. However, we had concerns people were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage them.

All the people we spoke with were complementary about the care and support provided by the staff although four people told us they had experienced some problems in the Summer/Autumn of 2012 when then agency had staffing problems. One person told us 'The staff are very good and will do anything I ask of them.' Another person said 'The staff generally arrive on time and always make sure I have everything I need before they leave, I am pleased with all aspects of the service.' However, three people felt that there was at times a lack of communication within the organisation and messages were not always passed on or action taken to address matters.

The staff we spoke with told us that the service had improved since the appointment of the new manager and they were generally happy with the support they received from the senior management team. Comments included "Our workload now is much more manageable than it was six months ago and I feel we are once again providing a good service" and "The staffing problems experienced by the agency in 2012 have improved significantly and we now have a more stable staff team."