Archived: York Helpers

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People were not kept safe because the provider did not have effective systems in place to recognise and report any potential abuse, which included neglect. The service did not have a system to manage accidents and incidents and to then learn from them. This meant people were not protected from avoidable harm.

People's records did not evidence that the risk of harm was regularly discussed with them so that risks were managed appropriately with them. This was needed so that their freedom and independence could be supported and promoted.

People requiring help with their medicines were not always kept safe because the provider did not have measures in place to ensure people received help and support at the agreed times when those people needed to take their medication. This placed people's health and well-being at risk.

People were not always kept safe as the provider had not ensured there were sufficient staffing levels in place to meet the needs of the people who used the service.

People were kept safe as staff used protective wear, like aprons and gloves when providing personal care. This minimised the risk of the spread of infection between people who were using the service.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to safeguarding, risk management, staffing and medicines.

Is the service effective?

Whilst people's care needs were assessed before they started using the service, there was little evidence that these needs were being kept under review. For example we identified that some people's care needs had changed, but their records had not been updated to reflect that change. The lack of up to date records increased the risk of people receiving unsafe or inappropriate care.

Whilst people told us that some staff had the skills and knowledge to meet their needs effectively, they also told us that some newer staff lacked initiative and did not have the skills they needed to provide the support people had agreed to. Some people questioned whether new staff were provided with the right training so that they could support people appropriately.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to assessing people's needs and staff training.

Is the service caring?

People told us mostly that care workers were friendly, kind and polite. Their comments included 'They treat me as a friend. They are very kind and caring and make time to listen to me.' Another said 'I want to stress certain carers (the long term more experienced carers) are absolutely brilliant. They are very helpful and really nice and friendly.' People though did have concerns about some of the newer care workers. Their comments included 'I do notice some of them lack initiative' and 'Some of the new workers are not so good. I wonder whether they are getting enough training.'

People were treated respectfully and their privacy and dignity needs were protected. All the people we spoke with told us that this aspect of people's care and support was always well managed.

Is the service responsive?

There was little evidence to show that in recent months the service had been consulting with people about their care needs. This meant the service was not checking with people that they were still getting the care they wanted and needed. This increased the risk that people received care and support they neither wanted nor needed. Or indeed the care and support they received was no longer appropriate because their care needs had changed.

Whilst the service had a complaints policy there was little evidence that complaints were investigated properly and addressed to the complainant's satisfaction. All the survey responses (seven) we received said they had had cause to complain about their care in the past 12 months. They commented 'Nothing was solved' and 'Didn't hear anything, so I gave up.'

We have asked the provider to tell us how they will make improvements and meet the requirements of the law in relation to involving people in planning their care.

Is the service well-led?

York Helpers did not have a robust way of monitoring how the service was operating. Although these processes were reported as being in place when last inspected by the Care Quality Commission (CQC) in June 2013, practically none of these were evident at this inspection. Senior management did not have systems in place to help them identify when things started to go wrong at the agency. They failed to take responsibility for things that happened in the service.

The service did not have a system to learn from accidents, incidents, safeguarding concerns, missed calls and medication errors. There was no effective system to continually review these incidents. There was no evidence of analysis of these events, or action plans to show what the service was doing to minimise the risk of a similar event happening again. This meant there was no opportunity to learn from these events.

There was a lack of good leadership and management. There has not been a registered manager in post for more than 18 months. This meant the manager had not been assessed by CQC as fit and able to manage a care service. CQC took enforcement action in early 2014 about this matter.

The management team did not have systems in place to assess and monitor that there were sufficient numbers of staff with the right competencies, knowledge and skills. This meant the service did not take timely action when these numbers started falling, which led to insufficient care workers being available for the people using the service.

Robust quality assurance systems were not in place. This meant 'failings' were not identified at an early stage. There were no processes in place to develop best practise that could be used to enable the service to be continually improving.

Recent changes in the management team had led to the staff team losing confidence in the organisation. Staff told us, and the records we looked at indicated that staff felt undervalued and demoralised. The effective processes that had been in place to support staff had lapsed.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to quality assurance, and the improvements they will make in relation to management of the service.

People told us the care they received was of a good standard and that in the main staff arrived on time. One person told us 'I know in advance who is coming and what time to expect them. This is very helpful; I can plan my days accordingly.'

The agency had clear systems in place for supporting people with medication and staff were trained in the safe handling of medicines.

All staff told us they thought morale was high. They said the management team were supportive and approachable. They felt there were enough skilled and experienced staff to meet people's needs, we saw evidence of this.

The agency had systems in place to make sure people were safely cared for. This included policies and procedures, training for staff and quality monitoring systems.