Hannah's Homecare Ltd

Updated 10 June 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

This inspection was undertaken by an inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave a short period of notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 12 May 2023 and ended on 18 May 2023. We visited the location’s office on 15 May 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with the registered manager and office staff during the site visit. We received feedback from 6 staff members and spoke with 5 people who used the service and 5 relatives, about their experience of the care provided.

We reviewed a range of records. This included 3 people's care records and medication records. We looked at 3 staff files in relation to safe recruitment. A variety of records relating to the management of the service, including audits were also reviewed.

Updated 10 June 2023

About the service

Hannah's Homecare is a domiciliary care agency, providing personal care to people in their own homes. At the time of the inspection there were 37 people receiving support.

People’s experience of using this service and what we found

Risks to people were not always assessed and managed robustly. Although some risk assessments were in place, they were not all accurate or consistent and some risks had not been assessed for all people. Care plans were not always updated when people’s needs changed. This meant staff may not have up to date information on how to meet people’s needs safely.

Medicines were administered by trained staff; however, people did not always receive their medicines as they were prescribed. For instance, the required four hours between doses of one medicine was not always adhered to. Records regarding the administration of medicines were not always clearly and robustly maintained.

Systems were in place to monitor the service and monitor quality and safety but were not always fully effective as they did not cover all aspects of the service and did not highlight all of the issues we raised during the inspection.

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; but the policies and systems in the service did not always support this practice. Records showed people signed to show their consent to planned care when able, but when mental capacity assessments were required to be completed, they were not always decision specific and best interest decisions were not clearly documented.

People and their relatives told us they felt safe with the support provided by Hannah’s Homecare. Staff were aware how to raise any safeguarding concerns and there were sufficient numbers of safely recruited staff available to meet people’s needs. People told us staff arrived on time and stayed for the planned amount of time and they usually received support from the same group of staff that knew them well.

People told us staff were well trained and knew their needs and how to support them. Staff were knowledgeable about actions they should take if people were unwell, and referrals were made to other professionals if there were concerns about people’s health and wellbeing. Staff told us they felt well supported in their jobs and records showed they received regular training and supervision and the provider had policies in place to help guide staff practice.

Feedback regarding the service provided to people was positive and the culture of the service helped ensure good outcomes for people. People, relatives and staff told us they felt the service was well managed. Systems were in place to gather people’s feedback regarding the service, such as surveys and a complaints procedure.

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 8 April 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service. We undertook a focused inspection to review the key questions of safe and well-led, and this was expanded onsite to include the key question of effective. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hannah’s Homecare Ltd on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to the management of risk and medicines at this inspection. We also made recommendations about the recording of people’s consent and governance systems. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.