Havant Homecare

Updated 14 September 2018

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 2 and 6 August 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because the location provides a domiciliary care service and we needed to be sure that the staff we needed to talk to would be available.

The inspection was carried out by one adult social care inspector. Before the inspection, we reviewed all the information we held about the service including previous inspection reports and notifications received by the Care Quality Commission. A notification is information about important events which the service is required to tell us about by law. Prior to the inspection we reviewed information included on the Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We used this information to help us decide what areas to focus on during our inspection.

Inspection activity started on 2 August 2018 and ended on 7 August 2018. We visited the office location to see the manager and office staff and to review care records and policies and procedures. We carried out telephone interviews with two people who used the service and we spoke to the relative of two people at the inspection location. We visited two people who received a service from the provider in their own homes and observed interactions between people and staff. We sent out nine questionnaires to people who used the service, and their friends or relatives. We received three responses from people and three responses from people's relatives and friends. We sent out four questionnaires to staff and we received four responses. We requested and received feedback on the service from a local authority social worker. Their responses are included within the body of the report. We spoke with the registered manager who is also the owner of this service, the community support worker the managing care worker, the training care worker and three care staff. Following the inspection, we received further information from the registered manager.

We reviewed records which included six people's care plans, visit records and Medicine Administration Records (MARs) staff training, recruitment, supervision records and staff meeting minutes. We also looked at records of incidents and complaints along with records relating to the management of the service, such as quality assurance audits.

This is the first inspection of this service since it was registered in July 2016.

Updated 14 September 2018

This inspection took place on the 2 and 6 August 2018 and was announced by giving the provider 48 hours' notice. We gave notice of this inspection to ensure the staff we needed to speak with were available.

Havant Branch is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older and younger adults, including people living with dementia, physical disabilities and sensory impairments. Not everyone using Havant Branch receives the regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection the service was supporting 14 people.

A registered manager was in place who was also the owner of this service. We have referred to them as the registered manager throughout this report. 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 and their relatives told us the registered manager and staff were exceptionally caring. People felt respected and valued by staff who provided kind and compassionate care, often going 'above and beyond' people's expectations. Staff demonstrated care for each other and for the people they supported. The registered manager led by example and promoted a strong person-centred culture and staff shared the registered manager's passion for providing a high-quality service for people.

People were promised they would never be cared for by a stranger and new staff were always introduced prior to supporting people by familiar staff or the registered manager. This was important to people and helped to build effective and trusting relationships between people and staff. People and their relatives told us they felt valued by staff who respected their privacy and dignity and these principles were central to the service ethos. Staff were sensitive to people's lifestyle choices in their own homes.

The registered manager provided an exceptional and distinctive level of leadership which placed people's experience at the heart of the service. People and their relatives and staff spoke highly of the registered manager and Staff described the registered manager as "Motivational, passionate and a cut above the rest."

There was a strong framework of accountability and people were consistently involved in developing and evaluating the service they received. Staff performance was monitored through regular spot checks and observed supervisions. People were asked for their feedback at reviews and by an annual satisfaction survey. Action was taken in response to people's feedback and when staff performance required improvement.

There was a strong emphasis on continuous learning and a culture of driving continuous improvements through training, incidents and feedback . The registered manager promoted an open and transparent culture so staff were confident to raise issues which allowed learning to take place.

People and their relatives told us the service provided was safe. Risks to people from abuse were identified and acted on to keep people safe. There was a culture of learning at the service which meant that when things went wrong this was used as an opportunity to drive continuous improvements to the service people received.

People were supported by staff who understood and followed plans to provide safe care that minimised risks to people's health and wellbeing. There were sufficient competent staff to care for people and they provided a consistent and reliable service. People knew which staff were coming at what time and confirmed that staff stayed for their allocated time and beyond when required. Staff were recruited safely and people valued the security provided by familiar and consistent staff.

People's medicines were managed safely and staff followed procedures to ensure people were protected from the spread of infections.

People were supported by staff who completed training to meet their needs effectively. Staff were supported in their role through supervisions and appraisals and their performance was monitored through spot checks and observations. People and their relatives were complimentary about the knowledge and skills of staff which had supported people to achieve positive outcomes.

Staff were vigilant about people's healthcare needs. This included advocating on behalf of people with healthcare services and supporting people with their healthcare needs. People's nutrition and hydration needs were known and monitored where appropriate to ensure they received sufficient food and drink.

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 supported this practice.

People received person-centred care based on a full assessment of their needs. A care plan was in place which described people's preferences and important information to guide staff as to how to provide person centred care. People had achieved positive outcomes because of the care provided.

People's communication needs were assessed, understood by staff and met. The registered manager added to the needs assessment during the inspection to ensure people were asked about all the protected characteristics under the Equalities Act (2010). This provides people with the opportunity to discuss their diverse needs should they wish to do so and supports person centred care.

A system was in place to enable people to raise their concerns and complaints. Records demonstrated complaints received were responded to in line with the company procedures. People and their relatives told us they were confident the registered manager would listen to them and act on any information of concern.

We received positive feedback from a person's relative about how they had been cared for at the end of their life. No one was being supported with end of life care at the time of our inspection. The registered manager improved the questions asked of people about their needs and preferences for end of life care during the inspection to ensure they would be known and respected by staff.