UKG Care Havant

UKG Care Havant is a domiciliary care agency which provides support and personal care to people living in their own home. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of our inspection 118 people were receiving a regulated activity from UKG Care Havant.

People’s experience of using this service and what we found

Risk assessments were completed for people which identified any risks but required further detail to ensure staff had the information they needed to mitigate risks

People told us they received safe care and treatment. Care staff understood the importance of safeguarding people, and they knew how to report any signs of abuse, or any accidents and incidents.

Staff had completed training in the safe administration of medicines and had their competency re-assessed annually. People were encouraged to maintain their independence to self-administer their own medicines, where possible. People who required support to administer medicines, were happy with how they were supported.

Staff received an induction into their role and had received appropriate training that equipped them to support people. Safe recruitment procedures were in place to help ensure only suitable staff were employed.

Staff felt they were supported by the management team. Although had felt stretched over the last year, with the need for more staff, they told us they felt things were improving.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People care needs had been assessed and they were involved in decisions about how they wanted to be supported. Care records were written in a sensitive and person-centred way.

The management team had processes for monitoring visits and endeavoured to ensure that office staff contacted people when care staff were held up or were running late for visits.

People were supported to maintain good health and well-being, and staff supported people to access their GP when needed.

Systems and processes were in place to monitor the service and identify and drive improvement. The manager had developed an action plan to ensure they were able to make any improvements needed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 25 December 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We received concerns in relation to poor leadership, care plans, medicines, staff allocation and complaints. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe, effective and well led sections of this full report.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for UKG Care Havant on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information, we may inspect sooner

UKG Care Havant is a is a domiciliary care agency providing personal care to people in their own homes. The service was supporting 40 people at the time of the inspection, including older people and those living with dementia, people with a physical disability and younger adults.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. 15 people were supported with personal care at the time of the inspection.

People’s experience of using this service and what we found

People and their relatives told us the service was safe and staff understood and acted on any risks to them. Some records about risks needed further guidance for staff, however people were mostly supported by familiar and consistent staff who knew them well and cared for them safely. The provider did not ask staff for their full employment history when they were recruited. This information is required to protect people from the employment of unsuitable staff. The registered manager told us they would ensure this happened in future. People’s medicines were managed safely, and people were protected from the risk of infection because staff used protective equipment. Incidents were used to identify improvements that could be made to people’s care and support.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. However, records and information about people’s mental capacity, legal representatives and legal consent required improvement to ensure people’s legal rights were upheld.

Systems were in place to monitor the safety and quality of the service; however, these had not been effective in identifying the shortfalls we found. The providers and registered manager were working together with staff to promote an open and positive culture in the service. Improvements were being made to the service and further initiatives were planned to ensure people and staff contributed to service development. People told us they were happy with the service they received.

People’s needs were assessed, and staff completed a robust induction process and on-going training to give them the skills and knowledge to meet people’s needs effectively. Staff were supported in their role and their competency to deliver care was checked. People told us they received the support they needed with food and drink and the service supported them, when necessary, to access healthcare support.

People and their relatives told us staff were kind and caring and treated them with dignity and respect. People were involved in decisions about how their care was delivered and were regularly asked about their experience of the service by the provider.

People’s needs at each of their care calls were described in their care plans and people told us their needs were met. Care plans were being updated to include more person-centred information, this is important, so staff understand people’s needs and preferences when they may not be able to express them. People and their relatives told us their concerns were dealt with promptly and the registered manager welcomed feedback. No one was being supported with end of life care at the time of the inspection. However, care plans and staff training were in place or being developed to ensure staff could meet people’s needs at this time.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 20 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to the application of the Mental Capacity Act (2005) and safe recruitment practices. Please see the action we have told the provider to take at the end of this report

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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.

We carried out a previous inspection of this service on 20 October 2015 where we rated the service requires improvement. We had identified some concerns relating to medicines management and the recording of medicines guidance within care plans. During this inspection in January 2017 we found these areas had been improved and we had no further concerns.

We visited the office on 27 January 2017. We carried out phone calls to people who used the service and their relatives on 30 and 31 January 2017. We gave the provider short notice of our inspection visit to the office as we needed to speak with staff and wanted to ensure the registered manager was available to speak with us.

People were supported by a strong, skilled and supported staff team. Staff knew people well and focused on ensuring they received the highest quality of care. Without exception people and their relatives spoke very highly of the staff who cared for and supported them. Comments included “We have a laugh and a joke they are all so nice and caring”, “They are all wonderful, every single one of them. The way they treat me and speak to me. We have a laugh. I can’t say anything but good things” and “I can’t praise them enough they are so kind and caring.”

The registered manager and staff gave us many examples of how they had gone ‘above and beyond’ for people and how this had made a difference for them. Staff told us their focus was on trying to make people happy and ensure they felt comfortable. For example, one member of staff had stayed with a person until they fell asleep one night as they were experiencing high levels of anxiety and would otherwise have been alone. This demonstrated the importance The Help placed on caring for people’s wellbeing and comfort as well as their physical needs.

People and staff benefited from a management team at The Help which valued staff’s contributions, skills and achievements. These were highlighted in a number of ways, including awards and newsletters. This ensured best practice and kindness were recognised and that these values were highlighted to the rest of the staff team for their learning and development.

People were protected from risks relating to their health, mobility, medicines, nutrition and behaviours. People’s individual risks had been assessed and staff had taken action to seek guidance where required and minimise identified risks. Where accidents and incidents had taken place, these had been reviewed and action had been taken to reduce the risk of reoccurrence. Staff supported people to take their medicines safely where required and as prescribed by their doctor.

Staff knew how to recognise possible signs of abuse which also helped protect people. Staff knew what signs to look out for and the procedures to follow should they need to report concerns. Safeguarding information and contact numbers for the relevant bodies were accessible. Staff told us they felt comfortable raising concerns.

Recruitment procedures were in place to help ensure only people of good character were employed by the home. Staff underwent Disclosure and Barring Service (police record) checks before they started work in order to ensure they were suitable to work with people who were vulnerable.

Staff had the competencies and information they required in order to meet people’s needs. Staff received sufficient training as well as regular supervision and appraisal. Staff’s knowledge and competencies were regularly checked in order to ensure they had a thorough understanding of the training they had received. Staff had a good understanding of the Mental Capacity Act 2005 (MCA) and put it into practice. People were asked for their consent prior to receiving any personal care. Communication methods used with people were individually tailored and enabled the delivery of exceptional care.

People and their relatives were involved in their care and staff respected people’s wishes. People’s care plans were personalised and included information about how they liked things to be done. People told us they liked to be independent and staff respected this, offering help when needed. The registered manager told us staff worked hard to enable people to retain and regain their independence and they regularly reduced people’s care packages where support was no longer needed.

People told us staff were almost always on time and had time to meet their needs in the way they wanted. The registered manager worked hard to ensure people had consistent staff teams. This helped people develop trusting and comfortable relationships with staff and increase confidence in having staff in their homes. Staff told us they tried to ring people with any changes, and the majority of people confirmed this happened.

People, their relatives and staff felt able to raise concerns or make a complaint. They were confident their concerns would be taken seriously. People told us they didn't have any complaints. Where complaints had been received they had been managed in line with the company policy.

There was open and effective management at the service led by the registered manager and the provider. Staff felt supported and valued. An audit system was in place to monitor the quality of the service people received. Records were clear, well organised and up-to-date. Unannounced checks to observe staff’s competency were carried out on a regular basis.