Archived: Hyde Park Care

Updated 1 June 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, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 23 April 2018 and the inspection team consisted of one inspector. We told the provider two days before our visit that we would be coming. We gave the provider notice of our inspection as we needed to make sure that someone was at the office in order for us to carry out the inspection.

Before we visited the service we checked the information that we held about the service and the service provider including notifications we had received from the provider about events and incidents affecting the safety and well-being of people. The provider also completed a Provider Information Return (PIR). The PIR 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. The PIR also provides data about the organisation and service.

Our previous inspection found breaches of regulation and following the inspection, the service provided us with an action plan which detailed what they were going to change and implement within the service in order to make improvements.

During our inspection we went to the provider’s office. We reviewed eight people’s care plans, six staff files, training records and records relating to the management of the service such as audits, policies and procedures. We spoke with seven people who used the service and four relatives. We also spoke with six care workers, two field care supervisors, two care coordinator, one office staff, the manager and the director.

Updated 1 June 2018

We undertook an announced inspection of Hyde Park Care on 23 April 2018.

Hyde Park Care is a domiciliary care agency registered to provide personal care to people in their own homes. At the time of our inspection, the service told us that they were providing care to 47 people. One person who received care from Hyde Park Care did not receive a regulated activity. CQC only inspect the service 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.

At the time of the inspection there was no registered manager in post. The previous registered manager left the organisation in March 2018. A new manager was appointed in March 2018 and we met the new manager during the inspection. The director of the service and the new manager confirmed that she would apply to register with the Care Quality Commission (CQC). 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 and associated Regulations about how the service is run.

The previous inspection on 4 April 2017 found three breaches of regulation and made one recommendation. We rated the service as "requires improvement". During this inspection 23 April 2018, we found that the service had made improvements in respect of care documentation, complaints recording, staff training, supervision, quality checks and audits. We also noted that the service had made some improvements in respect of their medicines management. However, there were still areas within the medicines management that required improvement. We also observed that the service had introduced various checks and audits. However, we noted that medicines audits were not consistent.

People who used the service and relatives told us that they were satisfied with the care provided and raised no concerns. People told us they were treated with respect and felt safe when cared for by the service. People and relatives spoke positively about care workers and management at the service.

Risk assessments were in place which detailed potential risks to people and how to protect people from harm. Systems and processes were in place to help protect people from the risk of harm. Care workers had received training in safeguarding adults and knew how to recognise and report any concerns or allegations of abuse.

Our previous inspection found numerous deficiencies in respect of medicines management and we found a breach of regulation in respect of this. During the inspection, we noted that the service had taken action in respect of this and made improvements. The service had introduced numerous systems to ensure that medicines were administered safely. However, we found that there were still some issues with regards to the completion of Medication Administration Records (MARs) and raised this with the manager. Following the inspection, the manager confirmed that they would change the system used for recording administration of medicines.

People we spoke with told us that there were no issues with regards to care worker’s punctuality and attendance. They told us that care workers were usually on time and if they were running late, the office called to inform them of the delay.

At the time of the previous inspection in April 2017, the service did not have an electronic system for monitoring care worker’s timekeeping and duration of their visit. During this inspection in April 2018, the service had a telelogging system in place which flagged up if a care worker had not logged a call to indicate they had arrived at the person’s home or that they were running late.

We looked at the recruitment records and found background checks for safer recruitment had been carried out to ensure staff were suitable to care for people.

Care workers we spoke with told us that they felt supported by the manager. They told us that management were approachable and they raised no concerns in respect of this. Our previous inspection found that care workers lacked knowledge of certain areas of care. Further, staff were not consistently supported to fulfil their roles and responsibilities through training, regular supervisions and appraisals. During this inspection we found that care workers had completed training and received regular supervisions and appraisals where necessary.

Care support plans were person centred and focused on the individual needs of people. Support plans included a section titled “Information about me” and “What you need to know and do to respect my lifestyle choices”. This included information about family and important relationships, how the person likes to live their life, places and events that are important to them, religious and cultural preferences and activities they like to do.

Care workers were aware of the importance of respecting people’s privacy and maintaining their dignity. They told us they gave people privacy whilst they undertook aspects of personal care. People who used the service told us that they felt confident in care provided by the service.

The service encouraged people to raise concerns. Our previous inspection found that the service did not consistently document what subsequent action was taken by the service following a complaint and we made a recommendation in respect of this. During this inspection, we noted that the service had taken appropriate action and we saw that complaints were fully documented and there was a clear record of what action the service had taken in response to the complaint.

There was a management structure in place with a team of care workers, field care supervisors, care coordinators, office staff, the manager and director. Staff spoke positively about the management and culture of the service and told us the management were approachable if they needed to raise any concerns.

We previously found that the service did not have effective systems and processes in place to assess, monitor and improve the quality of the services provided and we found a breach of regulation in respect of this. The previous inspection found that the service failed to carry out regular and consistent checks and audits in relation to staff spot checks, staff supervisions, care plans, complaints, medicines administration, staff attendance and punctuality. During this inspection we noted that the service had made improvements to address the breach of regulation. We noted that the service had introduced care plan audits and we saw evidence of this in people’s care records. The service also carried out regular and consistent staff spot checks and regular supervisions to monitor care workers. We also noted that the service had introduced an electronic telelogging system to monitor staff punctuality and attendance and this system was running effectively. The service also had a comprehensive system for monitoring complaints and ensuring that they were dealt with appropriately.

Our previous inspection found that there was not a documented and formal medicines administration audit in place. During this inspection in April 2018, we noted that the service had introduced a system for auditing medicines administration. However, we found that the system was not implemented consistently and had failed to consistently identify issues with regards to MARs. We discussed this with the manager and director and they confirmed that they would review their system to ensure that it was operating effectively.

The service had a system in place to obtain feedback from people and relatives about the quality of the service they received through telephone monitoring, home visits and review meetings. We also saw evidence that field care supervisors and care coordinators carried out regular and consistent spot checks to assess care worker's performance.

Staff we spoke with said that management and staff worked well together as a team and said that the morale within the service was positive. They said that management was approachable and that there was an open and transparent culture. Staff told us they would not hesitate to bring any concerns to management.