Holistic Community Care Limited

Holistic Care Community is a domiciliary care service registered to provide personal care and support to people in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection there were 259 people receiving personal care.

People’s experience of the service and what we found

The majority of people and their relatives were happy with the care and support provided. Comments included, “I am pleased with the service provided” and “I am very happy with my carers.” However, some people had experienced delays in their call visits. The provider had been successful in recruiting additional staff which had ensured sufficient staffing levels. People were supported by staff who were recruited safely. Staff received induction before they started providing care.

People were protected from the risk of avoidable harm. Comments included, “I feel safe with my carer” and “[Care staff] treat me so well.” Staff understood their responsibility to protect people from harm and to report concerns. They knew how to identify abuse and to whistle blow any concerns. Risk assessments were carried out and guidance put in place. This ensured staff were able to provide care in a safe manner. People received their medicines when required. Staff followed good hygienic practices to reduce the risk of spread of infection.

People received effective care as staff were supported to undertake their work. Staff received regular training and supervision to carry out their roles. People were supported to maintain good health and their well-being.

People told us they received care from regular care staff. This enabled them to develop positive and meaningful caring relationships. People were supported in a manner that maintained their dignity and privacy. They consented to the care provided to them. People were supported to maintain their independence and to make choices about their daily living.

People’s care needs were met. Care and support plans were reviewed and updated to reflect changes to each person’s needs. Staff supported people to access health services when required. People and their relatives knew how to raise concerns about their care.

People, their relatives and staff were happy with the management and leadership of the service. They felt their views were valued and considered. They described the registered manager as transparent and approachable. Quality assurances were undertaken on the care provided and improvements made when needed. Staff were encouraged to learn when things went wrong. The provider took action to prevent incidents from happening again. The registered manager worked in partnership with other agencies, health and social care professionals and external organisations to ensure people received care appropriate to their needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good, published on 10 October 2017.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Holistic Community Care provides personal care and support to people in their own homes in five London Boroughs. At the time of the inspection there were 251 people receiving personal care from the service.

The service had a registered manager in place. 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.

People did not always receive their medicines in line with good practice. At the time of the inspection care staff did not complete a Medicine Administration Record (MAR) and it was therefore unclear what medicines people had received. Following the inspection the provider sent us confirmation that a robust system for recording medicines administered had been implemented.

People were protected against the risk of harm and abuse. Staff received on-going training in safeguarding people. Staff had sufficient knowledge on how to respond and escalate allegations of abuse and knowledge of the provider’s whistleblowing policy. Risk management plans were reviewed regularly and gave staff clear guidance on how to protect people from identified risks.

People were supported by sufficient numbers of staff to safely meet their needs. Staff underwent robust recruitment procedures to ensure their suitability for the role. Staffing levels were monitored and additional staff recruited when required.

Staff received training to effectively meet people’s needs. Where training had lapsed, action plans were in place to ensure relevant courses were prioritised and spot checks and supervisions carried out to ensure staff delivered effective care. Staff reflected on their role and performance through supervisions and annual appraisals.

People were supported to communicate in a manner they preferred and understood. The service actively recruited staff that spoke the same primary language of people they supported.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. People confirmed staff sought their consent to care and treatment.

Where agreed in people’s care packages, stuff supported them to have access to sufficient amounts to eat and drink to meet their dietary and nutritional needs. Where concerns regarding people’s health and well-being were identified, this was shared with healthcare professionals in a timely manner.

People told us they received care and support from staff that demonstrated kindness, empathy and treated them with respect and maintained their dignity. Staff spoke of people they supported with compassion. People were encouraged to maintain their independence wherever possible. Staff demonstrated a clear understanding of the correlation of independence and self-esteem.

People had their confidentiality maintained and respected. Staff were aware of the importance of enabling only those with authorisation access to confidential records.

Care plans were reviewed regularly to reflect people’s changing needs. Where changes were made, these were shared with care staff to ensure they delivered responsive care to meet people’s needs. People were encouraged to make choices about their lives and the support they received. People confirmed staff respected their decisions.

Where agreed in people’s care packages staff supported them to participate in activities in the local community. Staff had sound knowledge of how to minimise the risk of social isolation and how to report their concerns.

People were aware of how to raise their concerns and make a complaint. Records reviewed demonstrated the provider ensured all complaints were fully investigated to ensure a positive outcome, in a timely manner.

People’s feedback was welcomed by the provider. Quality assurance questionnaires, audits, spot checks both in person and via the telephone were carried out regularly. Where issues were identified, the service then put plans in place to address the issues in a timely manner.

The registered manager actively sought partnership working to ensure people’s lives were enhanced and to improve the service provision.