Archived: Home First Haverhill

Haverhill Home First is a domiciliary care service who provide short-term re-enablement packages to people in their own homes. At the time of our inspection there were 27 people using the service. The service shares a registered manager and additional resources with two other Home First services in the area.

There was a registered manager in post although the service is not required to have one and the day-to-day management was handled by two team leaders. 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.

The service took a robust and thorough approach to keeping people safe by completing a comprehensive risk assessment prior to commencing a package of care. Assessments of people’s mobility, environment and medicines were carried out to identify risks and implement suitable control measures for staff to mitigate them. The service created a person-centred plan based on outcomes and goals for re-enablement, which provided a consistent method for staff to work to when delivering care. Rotas and the allocation of visits were managed effectively to enable staff to get to people on time and spend the correct amount of time providing their care and support on each visit. While there had been difficulty recruiting to the service which had resulted in some staffing shortages, the service utilised resources creatively to ensure that people always received care and were not placed at risk.

The service worked closely with other professionals as part of people’s re-enablement and were able to contribute effectively towards supporting people with their healthcare needs. If people required assistance with taking their medicines then they received this support from trained and competent staff who managed their medicines safely.

Staff received a wide range of training to undertake their duties effectively and were able to demonstrate how this training was put into practice. The staff team was experienced and skilled and demonstrated a strong commitment to providing positive outcomes for people. They were provided with regular supervision and performance reviews which encouraged them to share views and reflect upon their practice. They understood their roles and responsibilities and were knowledgeable about the ways in which people gave consent and how the Mental Capacity Act (2005) was applied in practice. The staff we spoke with demonstrated a caring attitude and understood how to treat people with dignity and respect. Staff meetings were held fortnightly and provided an opportunity for the team to meet and discuss issues affecting the service. New staff received a full induction into the service, and robust recruitment procedures were in place to ensure they had the skills and experience necessary for the role.

There were robust processes in place for monitoring quality and identifying improvements that needed to be made across the service. The management, leadership and culture within the service was empowering, transparent and consistent, and we found the overall governance and organisation of the systems used in the delivery of people’s care to be well managed and implemented at all levels.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us and the records we looked at.

Is the service safe?

Staff had undergone a thorough recruitment and induction process and had also received appropriate training and guidance including safeguarding of vulnerable adults. We saw that the provider had taken the appropriate action to protect people from abuse. They had followed the correct process for reporting safeguarding alerts to the local authority safeguarding team and the Care Quality Commission.

Records contained detailed assessments of people's needs that had been carried out prior to them commencing with the service. This ensured that the staff had the relevant skills and knowledge required to meet the individual's identified needs. The service had an occupational therapist attached to the team who worked closely with the staff, people who used the service and other health and social care professionals to promote and enable people to regain their independence.

Where people did not have the mental capacity to provide consent the provider complied with the requirements of the Mental Capacity Act 2005. Staff had received training in this area.

Is the service effective?

It was clear from what we saw and from speaking with staff that they understood people's care and support needs and that they knew the people well. People's health and care needs were assessed with them, and they were involved in writing their plans of care. Where this was not possible staff had sought views from relatives and other health care professionals.

People we spoke with were very complimentary about how the staff had enabled them to regain their independence.

Is the service caring?

People we spoke with told us the staff took the time to explain things clearly to them and listened to their responses. They were able to do things at their own pace and were not rushed. One person told us, "The staff very kind and well trained." Another person said, "l am a very independent person. They encourage me to do what I can for myself."

Is the service responsive?

We saw that arrangements had been put in place with people to enable them to change the time of their visits and the frequency when requested. We saw that where a person's needs had changed, such as an increase in their independence, the care plan and risk assessments had been reviewed and updated. Staff we spoke with informed us that they were informed of any changes to a person's care plan or risk assessment

Is the service well led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. We saw that the service ensured that the relevant health care professionals had been involved in assessing, planning and meeting people's changing health needs.

Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

The service had a quality assurance system in place. Records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuously improving.

Staff told us they were clear about their roles and responsibilities and that they had received refresher training and had excellent support and supervision from the manager.

We found improvements were required in relation to staff supervision, induction and training to ensure staff were able to carry out their role effectively. The service had robust recruitment procedures to ensure people using the service were protected.

People were having their needs met by the service who worked in cooperation with other health and social care agencies. We found that improvements in care records were required to ensure care staff were accountable for the care and support they were providing.