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Inspection Summary


Overall summary & rating

Requires improvement

Updated 25 May 2017

We carried out an unannounced inspection of Helping Hands on 27 February 2017.

Our last inspection of Helping Hands was in October 2015 when the service was rated as ‘requires improvement’ overall and for the key questions of safe, effective, and well-led. The key questions for caring and responsive were rated as good.

Helping Hands provides a 24 hour supported living service in Eccles, Salford. The service provides support to adults whose primary need for care is due to a learning or physical disability. Support is provided for people with varying needs and people with more complex needs were receiving one to one support.

Helping Hands is divided in to three separate accommodations, known as Number 19, the Milton Crescent and Bath house. At the time of the inspection there were 19 people living at the service.

During this inspection we found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to; good governance (two parts of the regulation) and staffing.

The service had a 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 2008 and associated Regulations about how the service is run.

People who used the service told us they felt safe and we found suitable safeguarding procedures in place which were designed to protect vulnerable people from abuse and the risk of abuse. The service had a robust recruitment process which included a Disclosure and Barring Service (DBS) check having been undertaken and suitable references obtained before new staff commenced employment.

We found there was no information recorded to guide staff when administering medicines which were prescribed to be given “when required” (PRN). Cream records and body maps were not in place to guide staff regarding application and we found omissions of staff signature on the MAR that had not been explored with staff as to how they had occurred. Records regarding the use of thickeners were not maintained and there was no record on the MAR to determine that this had been administered correctly.

People had risk assessments which were reviewed to meet people’s needs. People confirmed being involved in the assessments and planning of their health and social care. Regular reviews were undertaken collaboratively and people expressed feeling involved.

Staff demonstrated a good understanding of the requirements of the Mental Capacity Act (MCA) and we confirmed the service had engaged with professionals for consideration of application to the court of protection when people were deemed not to have capacity to consent to their care and treatment.

We saw there were gaps in staff training and there was no identified timeframe for completion of this training. The gaps included; MCA and deprivation of liberty safeguards (DoLS), positive behaviour management, autism awareness and learning disabilities. The service is designed to support people with a learning disability so this training is fundamental in ensuring staff have the required knowledge and skills to meet people’s needs. This gap had been identified at our previous inspection and remained an outstanding requirement. This meant staff had not been provided sufficient training to support them in their role.

People were supported by familiar staff that understood their needs and individual communication requirements to ensure people’s needs were met. Staff encouraged people to maintain their independence and to develop their confidence to empower people receiving support to develop new skills.

People’s nutritional needs were closely monitored and additional support provided when people were identified as losing weight. People told us they chose their meals and were supported by staff to shop for the meal provisions. People were encouraged to participate in meal preparation and told us they were given sufficient amounts to eat and drink.

People were promoted to live full and active lives. Activities were meaningful and reflected people’s interests and individual hobbies.

Staff described the management to be open, supportive and approachable. Staff talked about their jobs positively and with pride. Staff told us they were fully supported by the management and that the deputy and registered manager were instrumental in supporting people’s care.

There were systems in place to monitor the quality of the service being provided, however it was not effective given the areas of concern we identified in relation to medication records, audits and training.

Inspection areas

Safe

Requires improvement

Updated 25 May 2017

Not all aspects of the service were safe.

Risk assessments were in place and support plans provided staff guidance on mitigating the risks.

Medicine documentation required strengthening to support staff. PRN protocol and cream charts were not in place to provide staff with appropriate guidance.

People who used the service told us they felt safe and staff had a good understanding of safeguarding procedures.

Effective

Requires improvement

Updated 25 May 2017

Not all aspects of the service were effective.

People were supported by staff that demonstrated a good understanding of the Mental Capacity Act 2005. The local authority had been informed regarding consideration of an application to the court of protection.

Staff told us they received enough training but we found gaps in the training staff had received and there was no identified timeframe for completion.

People received enough to eat and drink and were supported by staff where necessary.

Caring

Good

Updated 25 May 2017

The service was caring.

Staff were kind, compassionate and friendly. They respected people's choices and opinions.

Relatives told us they were happy with the care and support provided and were welcomed to visit their relative at any time.

Staff had a good understanding of how to treat people with dignity and respect and promote people’s independence.

Responsive

Good

Updated 25 May 2017

The service was responsive.

Staff were knowledgeable about people's choices and people’s preferences were taken into account by the staff that were providing their care and support.

An assessment of people’s needs was undertaken when they first began using the service.

There was a complaints procedure available and complaints received had been responded to appropriately.

Well-led

Requires improvement

Updated 25 May 2017

Not all aspects of the service were well-led.

The registered manager was visible and involved in providing people’s care and support. Staff had opportunities to voice their opinion and raise concerns informally and more formally through supervision and team meetings.

Although audits and quality assurance systems were in place, they were not wide enough in scope to be fully effective in identifying the concerns we found during the inspection.

The service had relevant policies and procedures in place which the registered manager was in the process of reviewing and updating at the time of inspection.