Helping Hands Live in Regional

Updated 16 August 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.

We reviewed the information we held about the service. We looked at information received from the statutory notifications the provider had sent to us and commissioners of the service. A statutory notification is information about important events which the provider is required to send to us by law. Commissioners are people who work to find appropriate care and support services which are paid for by the local authority.

Before the inspection visits, the provider completed 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 found the PIR reflected the service provided.

The inspection was conducted by two inspectors on 28 June 2018 and one inspector on 29 June 2018. Two experts by experience contacted people by telephone to ask them what they thought about the service they received. An expert-by-experience is someone who has personal experience of using, or caring for someone who has used this type of service.

Before our inspection visit we contacted 50 people who used the service, 50 relatives of people who used the service, and all the members of care staff providing people with care and support in their own home. We asked people to take part in a survey, and used the outcome of this survey to inform our planning of the inspection. We received feedback from 16 people who used the service, four people’s relatives and 265 care staff. During the inspection process we received feedback from a further 34 people and 22 relatives of people who used the ‘live in’ service. We also received feedback from another 30 members of care staff and three commissioners of services.

During our inspection visits at the office, we spoke with the chief operating officer, the director of people and performance, the group operations director, the finance director, four registered managers which included a clinical lead manager, a senior quality assurance manager, the national support manager, a training manager, the head of the ‘live in’ service and two managers of ‘live in’ care teams.

We checked whether staff had been recruited safely, were trained to deliver the care and support people required and that staff received appropriate support to continue their professional development.

We looked at a range of records about people’s care including seven care files. We also looked at other records relating to people’s care such as medicine records, and the clinical support they received. This was to assess whether the care people needed was being provided. We reviewed records of the checks the registered managers and the provider made to assure themselves people received a quality service.

Updated 16 August 2018

This inspection took place on 28 June 2018 and 29 June 2018. On both days, the inspection was announced due to the amount of people this agency supported. The provider was given five days’ notice of our inspection visit to ensure senior management, registered managers, care staff and associated records were available when we visited the office.

Helping Hands Live-in National is a domiciliary care agency which provides personal care and support to people in their own homes nationwide as a ‘live in’ service, which supports people who may have complex care needs. Care staff would usually be on site in the person’s home up to 24 hours per day.

At the time of our inspection visit, the agency supported more than 750 people. This was the first time the service had been inspected under its current registration. However, the service was inspected previously in June 2016 under a different registration, when we found the provider was compliant with the essential standards described in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. We rated the service as ‘Good’ in all areas.

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. Helping Hands employed several registered managers at this location. There were three registered managers in post, and two registered manager posts were being filled at the time of our visit, both of these registered manager posts had been recruited to. Both new appointees were progressing their registration with CQC, and one was due to commence their employment. Each regional area, North, South, East and Central had a manager (or registered manager) responsible for the staff and the delivery of care to people using the service, within those regions. In addition, there was a registered manager appointed to manage clinical support and clinical training for staff.

People felt safe using the service and staff understood how to protect people from abuse and keep people safe. There were procedures to manage identified risks with people’s care and for managing people’s medicines safely. Checks were carried out on staff during the recruitment process to make sure they were suitable to work with people who used the service.

There were enough staff to deliver the care and support people required and people usually received care from a consistent staff team. People told us staff were friendly, respectful and caring and had the right care skills to provide the care and support they required. Staff received an induction when they started working for the service and completed training to support them in meeting people’s needs. Staff felt the training provided them with the right skills and knowledge to support people safely and effectively.

The provider understood the principles of the Mental Capacity Act (MCA), and staff respected people’s decisions and gained people’s consent before they provided personal care. People were protected from the spread of infection, as staff were trained in how to use preventative measures such as protective gloves and clothing to prevent cross contamination.

Care plans contained relevant information for staff to help them provide the personalised care people required. People knew how to complain and information about making a complaint was available to them. Staff said they could raise any concerns or issues with the provider, registered managers, and their immediate line manager knowing they would be listened to and acted on.

There were processes in place to monitor the quality of the service provided and to understand the experiences of people who used the service. This was through regular communication with people and staff, returned satisfaction surveys, staff meetings, spot checks on care staff and a programme of checks, audits, senior management meetings and operational board meetings.

The provider demonstrated strong leadership. Staff felt committed to the provider's vision and values and involved in how the service developed and improved. Examples of the best staff practices were celebrated. The leadership team was proactive in its response to trends revealed by its detailed analysis feedback and lessons learned from accidents, complaints and incidents.

The provider worked closely in partnership with a range of external organisations that were leaders in their field, to continuously improve the standard of care offered by staff at Helping Hands.