Harcombe Valley Care Limited

Updated 22 January 2019

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This announced inspection took place on 11,13 and 19 December 2018. The inspection team consisted of two adult social care inspectors and an expert by experience. An expert by experience is a person who has personal experience of caring for someone who uses this type of care service.

We spoke with people who were new to the service and to people who had been supported by the agency for a number of years. We met with three people who received a service and two relatives. We also received further feedback from five people and six relatives who could tell us about their experiences.

The provider completed a Provider Information Return (PIR). This 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. We reviewed the information included in the PIR along with information we held about the home. This included previous inspection reports and notifications sent to us. A notification is information about important events which the service is required to send us by law. This enabled us to ensure we were addressing any potential areas of concern.

We spoke with three members of staff, the registered manager and the nominated individual. We reviewed two people’s care file, staff training records and a selection of records relating to the management of the service.

Updated 22 January 2019

This inspection took place on 11,13 and 19 December 2018. We gave the service 48 hours’ notice of the inspection visit because it is a small domiciliary care agency and the registered manager works as part of the care team. We brought this inspection forward because of a safeguarding concern in connection with one individual. The outcome of a safeguarding meeting was for the registered manager and the nominated individual to investigate the allegation.

Harcombe Valley Care Limited is registered with the Care Quality Commission (CQC) to provide personal care to people within their own homes. At the time of our inspection, the service was providing personal care and support to 33 people. When we visited there was a registered manager in post. 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.

People who used the services and the feedback was overwhelmingly positive about their experiences. The registered manager and their staff went the ‘extra mile’ to help prevent people being socially isolated and responded quickly at times of personal crisis for people using the service. People said "They are lovely. They are all very nice and all very caring”, "I can’t fault them, they are lovely" and “The carers are always extremely courteous and helpful.” Relatives were equally positive about the approach of the care workers. One relative commented “They are kind to her. This service was recommended by a friend and I have to say that I find them impressive.” Another relative said “They are kind. I find them wonderful, I really do."

People were treated as individuals and were not judged when their behaviour was challenging towards staff. They recognised the frustrations of people when they became reliant on others and the impact this could have on their mental wellbeing. Staff were clear only experienced staff would be rostered to work with the person. They described how they altered their body language, voice tone and topics of conversation to reduce areas of potential conflict which meant the person accepted the support they needed.

People were supported by staff who were skilled and understood their needs. Since the last inspection, steps had been taken to improve the staff group’s knowledge of the Mental Capacity Act 2005 (MCA). Information was in place to ensure people’s legal rights were protected. A relative said “They seem to know exactly what her needs are and what needs doing.” Staff spoke confidently about the care they delivered and understood how they contributed to people’s health and wellbeing. People said “From day one it was obvious they were well trained.”

People's nutritional needs were met; staff supported some people with meal preparation. Care plans for each person held detailed information about their dietary needs, including likes and dislikes. People said “I tell them what I want for lunch and they do it. They know how I like things cooked.”

Referrals were appropriately made to health care services when people needs changed. Staff recognised the importance of maintaining people’s mental well-being, for example taking time to reassure them and address any misunderstandings due to the person’s anxiety. To help ensure care staff understood people’s needs there were fact sheets to help them understand people’s medical conditions.

People said they felt safe because the staff group were kind and reliable. People continued to be supported by staff who respected their privacy and dignity. Staff relationships with the people they supported continued to be caring and supportive. There was a stable staff group which helped ensure a consistent approach. Staffing arrangements were flexible to meet people’s individual needs and to respond to changes.

There was a consistent approach to gain people's consent to care and treatment in line with requirements of the legislation and guidance. People were supported to maintain good health and had access to appropriate services, which ensured they received on-going healthcare support. Medicine administration, recording and auditing was safe. People was satisfied with the infection control practices of staff.

Risk assessments identified when people could be at risk and covered people's physical and mental health needs and the environment they lived in. Feedback from people and staff confirmed the provider recruited staff who suited the caring values of the service and recognised the importance of team work to provide consistent and safe care. People were protected from abuse because the provider understood their safeguarding responsibilities.

There were systems in place to gain people's views and to address concerns and complaints. People were protected from abuse because the provider understood their safeguarding responsibilities. The service continued to provide well-led care to people. The service was well run by the registered manager and the nominated individual. Senior staff assisted the management team with reviews and spot checks to ensure people received a good quality service. Feedback from people using the service and quality assurance records showed this had been achieved.