Background to this inspection
Updated
29 October 2016
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 9 September 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service; we needed to be sure that someone would be in.
The inspection team consisted of two adult social care inspectors who visited the provider’s premises and an expert by experience who spoke by telephone to people who used the service and their relatives. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
At the time of our inspection there were 36 people using the service who received personal care. We spoke on the telephone with six people who used the service and seven relatives of people who used the service. We spoke with six members of staff, the office manager and the registered provider. We spent time looking at documents and records that related to people’s care and the management of the service. We looked at four people’s care and support plans.
Before our inspection, we reviewed all the information we held about the service, including previous inspection reports. We contacted the local authority and Healthwatch. Healthwatch feedback stated they had no comments or concerns. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. The local authority told us they had no reported concerns.
We usually ask registered providers to send us a 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 did not ask the provider to complete a PIR prior to this inspection.
Updated
29 October 2016
This was an announced inspection carried out on 9 September 2016. At the last inspection in December 2015, we found a total of three breaches which related to the safe management of medicines, recruitment procedures and lack of governance. At this inspection we found some improvements had been made.
Caring Hearts and Hands provides personal care and support to people living in their own homes in all areas of Leeds. The office, based in the Horsforth area of Leeds is staffed Monday to Friday during office hours. An out of hour’s phone service was available.
There was a registered provider in post who fulfilled the role of registered manager. 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 and associated Regulations about how the service is run.
We found there were not always appropriate arrangements for the safe handling of medicines, with poor documentation and a lack of effective medicine audits. The registered provider had introduced a range of quality audits; however, these were not always effective. We saw the mental capacity assessments did not contain the decisions people were unable to make and not all staff had received Mental Capacity Act (MCA) training.
People and their relatives told us they felt safe with staff and the care they received. We found there were appropriate systems in place to protect people from risk of harm. They said they were happy with the staff who were kind and caring. People told us they were treated with dignity and respect.
People were provided with care and support by staff who had the appropriate knowledge and training and there were appropriate numbers of staff to safely and effectively meet people’s needs. Recruitment processes were managed safely. Staff told us they had received induction and on-going support. Staff were also offered opportunities for on-going development. Supervisions and appraisals had taken place.
People’s care and support needs were assessed and care plans identified how care and support should be delivered. Care and support was found to be delivered in line with people's care plans and people were consulted about the care and support required. We saw the care plans were reviewed on a regular basis to make sure they provided accurate and up to date information.
People were supported to access a range of healthcare professionals when needed and where the service provided nutritional support, people's individual dislikes and needs were supported to enable people to eat a balanced and healthy diet.
A complaints procedure was in place which enabled people to raise any concerns or complaints about the care or support they received.
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we have told the provider to take at the end of this report.