Background to this inspection
Updated
3 April 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 11 and 14 January 2019 and was announced. We gave the service 48 hours’ notice of our intention to inspect because the service is small and we wanted to be sure someone would be in the office.
This inspection was carried out by one adult social care inspector and an Expert by Experience. An expert by experience is a person who has experience of using or cares for someone who uses adult social care services.
Prior to the inspection we gathered information from a range of sources, including the local authority safeguarding teams, notifications the provider is obliged to send us, and the provider information return (PIR). This is information we require providers to send us at least once annually to give key information about the service, what the service does well and improvements they plan to make.
We reviewed a range of documents relating to people’s care and the operation of the service, including five people’s care plans, four staff personnel files, surveys and quality monitoring documents.
During the inspection we spoke with four staff including the registered manager and care staff, and four people who used the service over the telephone. We also conducted a home visit to speak with someone who used the service.
Updated
3 April 2019
This inspection took place on 11 and 14 January 2019 and was announced. At the last inspection, in January 2018 we found two breaches of the regulations, Regulation 12 (Safe Care and Treatment) and Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection the service continued to breach Regulation 17 and remained ‘requires improvement’ overall.
We asked the provider to complete an action plan to show what they would do and by when to improve the key question; 'Is the service safe?', 'Is the service effective?', 'Is the service responsive?' and 'Is the service well led?' to a rating of at least good. At this inspection, we saw some areas of improvement. However, the service remained in breach of regulation 17.
Helping Hand Care Services Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and younger disabled adults. At the time of the inspection there were 35 people using the service.
There was a registered manager in post at the time of the 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.
Medication administration records were not consistently completed to demonstrate people received their medicines as required. There was no formal audit process for medicines administration records, so it was not clear that issues had been identified and actions taken.
Care plans were not always reviewed regularly, and the level of person-centred information was not always consistent, with some templates and documents left blank. Some information about how people wanted their needs met was provided. However, this was not followed up with actions for staff to take. There was no audit process in place to ensure care plans contained relevant information.
People told us they found the service safe, and there were enough staff to meet their needs. Staff had been recruited safely. There were systems and processes in place to protect vulnerable people from abuse.
Staff told us they received good standards of training and support in the form of an induction, training modules, supervisions and spot checks. People were confident that staff had the skills necessary to meet their needs.
Staff understood their role in helping people maintain a healthy lifestyle which included a good diet. People told us staff were attentive to their clinical needs and documents showed the service worked positively with other healthcare agencies.
People’s health and wellbeing was monitored effectively, with their food and fluid choices taken into account. The registered manager understood their role in upholding the principles of the Mental Capacity Act 2005, and where people had capacity to make decisions this was clearly recorded and respected.
People told us staff were kind, caring and compassionate. Staff maintained people’s independence and upheld their privacy and dignity.
There were systems and processes in place for people to raise complaints and for these complaints to be investigated appropriately. People told us they were confident they knew how to complain and issues would be addressed.
People and staff told us that senior staff were approachable and there was a positive working culture at the service. Furthermore, they would recommend the service both to work for and receive care from.
You can see what action we told the provider to take at the back of the full version of the report.