Archived: Homecare 4u NorthWest

Updated 3 March 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.

The inspection was brought forward due to recent safeguard investigations that had been substantiated by the local authority. The information shared with CQC about the incidents indicated potential concerns about the on-going risk management of falls and risk management of pressure care. One incident is subject to a coroner’s inquest and as a result this inspection did not examine the circumstances of the incident. However this inspection examined the services management of risks in relation to falls and pressure sores.

Since the last inspection we had been liaising with Stockport local authority quality assurance team and we considered this information as part of the planning process for this inspection.

This inspection was carried out over three days on the 4, 11 and 15 January 2018. In line with our current methodology for inspecting domiciliary care agencies this inspection was announced two days prior to our visit. This was to ensure the registered manager or other responsible person would be available to assist with the inspection. The inspection team consisted of one adult social care inspector. We telephoned clients who used the service and their relatives to gain their views and opinions about the service being provided.

Before the inspection we reviewed information that we held about the service and the service provider. This included safeguarding and incident notifications which the provider had told us about. Statutory notifications are information the provider is legally required to send to us about significant events such as accidents, injuries and safeguarding notifications.

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.

During this inspection we spoke with the registered manager, the deputy, two care coordinators, one senior carer, four care staff, ten clients being provided with support and one relative. This gave us a wide insight into their views across all areas of the service.

During the three days of inspection, we reviewed a variety of documents to review how the domiciliary care agency was managed. These included, care records for five clients to see if their records were accurate and reflected their needs. We reviewed five staff recruitment files, staff training, supervision records, policies and procedures, staff duty rotas and records in relation to the management of the service such as safety checks and quality assurance systems.

We also checked that the previous Care Quality Commission rating for the service (Requires improvement) was prominently displayed for people to see. The last inspection report and rating was displayed in the office. The service has had problems with their website and it has not been accessible to the public. The registered manager advised that once it was up and running they would ensure they provide access to their latest inspection report and rating.

Updated 3 March 2018

This was an announced inspection carried out over three days on the 4, 11 and 15 January 2018. The inspection was announced to ensure that the registered manager or other responsible person would be available to assist with the inspection visit and to ensure people using the service were available to speak to us. At the last inspection on July 2017 we rated the service as requires improvement overall. We identified some recommendations for improvements needed in relation to training and communications. This inspection was to check satisfactory improvements had been made and to review the ratings. At this inspection we found improvements to the service had been made.

Homecare 4U is registered with the Care Quality Commission (CQC) to provide personal care to people in their own homes in the community. This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. Not everyone using Homecare4U receives 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. They provide support to adults who live in the Stockport area. At the time of the inspection the service supported 102 people in their own homes.

There was a registered manager at the service. 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.

We received positive comments from people who used the service (clients are the term used by the registered provider for people receiving a service), relatives and staff. All of the clients and relatives we spoke with told us they felt safe in the care of the staff who worked for Homecare4U. Clients told us they usually had the same staff team supporting them. This meant that staff knew the people they provided care and support to very well.

We found there were enough staff to make sure people received the care needed. Clients and relatives told us care workers were generally on time. The provider had an effective system in place to monitor the staffing levels against the needs of people who used the service.

Staff were given appropriate support through a programme of face to face training, regular supervision, spot checks of their work and an annual appraisal. Staff said the training provided them with the skills and knowledge they needed to do their jobs.

Staff were recruited following a safe and robust process to make sure they were suitable to work with vulnerable people.

Clients' care plans contained up to date, detailed information about their care and support, including risk assessments and action plans. Risk procedures had been revised and improved to minimise the risk of harm to people using the service with improvements to recording the management of risks. People were involved in the planning and review of their care, this information was held in files at their home. Clients told us how information they shared with staff was included in their care file and helped the staff to understand what help they needed.

The complaints procedure was explained in the 'service user guide' which was provided to people when they started with the service. Clients and their relatives told us they knew how to raise a concern. The provider had an effective system in place to investigate and respond openly to complaints.

The registered provider and registered manager used a variety of methods to assess and monitor the quality of the service. These included regular reviews with clients and spot checks whilst staff carried out their caring duties and care reviews. We found some records had not been updated with the dates and staff names/signatures to show the record had been updated and by whom.

We saw appropriate actions were taken in response to any accidents/ incidents and previous safeguard investigations. The service had investigated them to consider potential causes of any injuries, and took appropriate actions to reduce any future potential risk. Evidence showed the provider has mitigated the risks appropriately and steps taken had reduced likelihoods of those risks occurring. However the registered manager recognised they needed to submit notifications of incidents to CQC in a timelier manner.