- Homecare service
Heritage Healthcare York
Important:
This service was previously registered at a different address - see old profile
All Inspections
23 November 2017
During a routine inspection
At the last inspection, the service was rated Good. At this inspection we found the service remained Good.
At the last inspection in October 2015, we asked the provider to take action to make improvements to record keeping and this action has been completed.
We gave the service 48 hours’ notice of the inspection visit because 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 on 23 November 2017 and ended on 11 December 2017. It included visits to people in their own homes on the 29 November 2017 and discussions with care workers on the 11 December 2017. We visited the office location on 23 November 2017 to see the manager and office staff; and to review care records and policies and procedures.
There was a registered manager in post who supported us during our inspection. 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.
Systems and processes were maintained to record, evaluate and action any outcomes where safeguarding concerns had been raised which helped to keep people safe from avoidable harm and abuse.
The provider ensured there were sufficient skilled and qualified care workers to meet people's individual needs and preferences.
People received their medicines as prescribed and safe systems were in place to manage people's medicines.
People were supported to have maximum choice and control of their lives and care workers supported them in the least restrictive way possible. The policies and systems in the service supported this practice.
People and their relatives were encouraged to participate in the planning of their care and support.
People were supported to eat healthily and any dietary needs were assessed, recorded and responded to.
Care workers had a good understanding of people's needs and were kind and caring. They understood the importance of respecting people's dignity and upholding their right to privacy.
People were encouraged to live full lives. The provider held coffee mornings and promoted free transport to encourage people to avoid social isolation.
There was information available on how to complain People were encouraged to raise their concerns and these were responded to.
There were systems of audit in place to check, monitor and improve the quality of the service. Associated outcomes and actions were recorded and these were reviewed for their effectiveness.
The provider worked effectively with external agencies and health and social care professionals to provide consistent care.
Everybody spoke positively about the way the service was managed. Care workers understood their levels of responsibility and knew when to escalate any concerns.
Further information is in the detailed findings below.
8 and 27 October 2015
During a routine inspection
We inspected this service between 8 and 27 October 2015. The inspection was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in the location offices when we visited.
Heritage Healthcare York is a domiciliary care agency and is registered to provide personal care to people in their own homes. At the time of our inspection the service was supporting 76 people in and around the City of York.
The service was registered at a new location in April 2015 and this was the first inspection of the service at this location.
The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager registered with the Care Quality Commission (CQC). 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.
Care Workers we spoke with understood the signs of abuse and knew what action to take to keep people using the service safe. We found that people’s needs were assessed and risk assessments put in place to reduce risks and prevent avoidable harm.
The service had a safe recruitment process to make sure only people considered suitable to work with vulnerable client groups were employed. Meanwhile the service had systems in place to ensure that there were enough staff to meet people’s needs in the event of sicknesses and absences.
Where care workers supported people using the service to take their medication, we found that this was not always accurately recorded on Medication Administration Records. This could increase the risk of medication errors occurring. We discussed this with the registered manager and they sent us information on a new system they had introduced to more closely monitor and respond to errors with recording. We will review how effective this system is at our next inspection of this service.
There was an effective induction process and on-going training to equip care workers with the skills and knowledge to carry out their roles effectively. Although there were some gaps in care workers training the registered manager was taking steps to enable them to deliver all training in-house and ensure that care workers training would be up-to-date by the end of the year.
We found that people were supported to eat and drink enough and, where necessary, supported to access healthcare service to promote and maintain their health and wellbeing.
Care workers supported people to make decisions wherever possible, whilst decisions made on people’s behalf were done so in line with relevant legislation and guidance. People using the service told us that they felt listened to, involved in creating their care plans and involved in decisions about the care provided. People reported that they felt their privacy and dignity were respected and were consistently positive about their care workers who were described as knowledgeable, well-trained as well as caring and compassionate.
We found that care plans were person centred and the service had a system in place to share information so that carers could provide personalised support that was responsive to people’s changing needs. The registered manager appropriately responded to compliments and complaints.
People we spoke with told us that the registered manager was approachable and that the service was well-led. We saw that the registered manager provided care to people using the service and used this time to monitor the quality of support provided and respond to comments or concerns. The registered manager also completed spot checks and competency checks of care workers practice to make sure they provided quality person centred care. However, we found that records were not always well-maintained and that the service did not have a formal system in place to audit care plans, risk assessments and medication administration records. This meant that some gaps in records had not been identified and addressed. We have made a recommendation about this in our report.