Harmony Healthcare

Updated 2 July 2022

The inspection

We carried out this performance review and assessment under Section 46 of the Health and Social Care Act 2008 (the Act). We checked whether the provider was meeting the legal requirements of the regulations associated with the Act and looked at the quality of the service to provide a rating.

Unlike our standard approach to assessing performance, we did not physically visit the office of the location. This is a new approach we have introduced to reviewing and assessing performance of some care at home providers. Instead of visiting the office location we use technology such as electronic file sharing and video or phone calls to engage with people using the service, their relatives and staff.

Inspection team

One inspector and an Expert by Experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides nursing and personal care to children and young people living in their own homes.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave a short notice period of the inspection because we needed to ask the registered manager to send us information and to obtain people’s consent to receive a telephone call from us.

Inspection activity started on 10 June 2022 and ended on 17 June 2022.

What we did before inspection

We reviewed information we had received about the service since its registration, including notifications of significant events. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We used all of this information to plan our inspection.

During the inspection

We spoke with the registered manager and the provider’s director of homecare via Microsoft Teams about how the service was planned and managed.

We spoke with nine families to hear their feedback about the care their children received from the agency. We received feedback from four professionals who had worked with the service and from eight staff about the training, support and information they received.

We reviewed information sent to us by the provider, including care plans and risk assessments for three people, medicines administration records for five people, recruitment records for 10 staff, training records, accident and incident records, quality audits, meeting minutes, the complaints log and the agency’s business continuity plan.

After the inspection

We met with the registered manager and the provider’s director of homecare via Microsoft Teams to share the feedback we had heard about the service.

Updated 2 July 2022

About the service

Harmony Healthcare provides nursing and personal care to people living in their own homes. The agency was supporting 22 people at the time of our inspection, 18 of whom were children and four of whom were young adults. Many of the children and young people using the service had complex needs, including epilepsy and needs relating to eating, drinking, breathing and communication.

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

Families said staff provided care in a safe way, including when they used any equipment involved in their children’s care. Risk assessments had been carried out to identify and minimise any risks involved in children and young people’s care. Medicines were managed safely. Staff wore appropriate personal protective equipment (PPE) when they provided care and protected children and young people from the risk of infection.

Staff understood their responsibilities in protecting children and young people from abuse and knew how to report any concerns they had. The provider’s recruitment procedures helped ensure only suitable staff were employed.

Staff had an induction when they started work and had access to the training they needed to carry out their roles. Staff were well-supported by the management team and had access to support and advice when they needed this, including through regular clinical supervision. The clinical management team carried out regular spot checks to ensure staff were providing care in line with best practice.

Children’s needs were assessed before they used the agency to ensure staff had the skills and training they needed to provide their care. When a team of suitable staff had been identified, they met with the clinical team to discuss how the package of care would be managed. Families and their children were encouraged to meet the staff allocated to their care team before they began to use the service.

Staff monitored children’s health effectively and responded prompt action if they became unwell. Professionals told us staff worked collaboratively with them to ensure children’s healthcare needs were met.

Children and young 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.

Families told us staff were kind and caring and said their children had established positive relationships with the staff who provided their care. Families said staff worked in partnership with them to ensure their children received the care they needed.

Staff supported children and young people to take part in activities, pursue their interests, and to be part of their community, including attending school. Staff respected children’s and families’ cultural and religious needs.

Families told us communication from the agency was good and said they were encouraged to give feedback about the care their children received. Complaints had been investigated appropriately and used as opportunities to improve the service.

The agency had an established management team with clear lines of responsibility. The registered manager had relevant experience for their role and provided good clinical leadership. There were effective systems to monitor quality and safety, including audits of key areas of the service. The agency worked well with other professionals to ensure children received co-ordinated care that met their individual needs.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were the underpinning principles of Right support, right care, right culture.

Right support:

The model of care being provided maximised children and young people’s choice, control and independence.

Right care:

Children and young people’s care was person-centred and promoted their dignity, privacy and human rights.

Right culture:

The ethos, values, attitudes and behaviours of leaders and care staff ensured children and young people’s led confident, inclusive and empowered lives.

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

Rating at last inspection

This service was registered with us on 8 January 2021 and this is the first inspection.

Why we inspected

This was a planned inspection based on the date the service was registered with us.

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.