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Inspection Summary


Overall summary & rating

Good

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 res

Inspection areas

Safe

Good

Updated 22 January 2019

The service continued to be safe.

Effective

Good

Updated 22 January 2019

The service continued to be effective.

Caring

Good

Updated 22 January 2019

The service continued to be caring.

Responsive

Good

Updated 22 January 2019

The service continued to be responsive.

Well-led

Good

Updated 22 January 2019

The service continued to be well led.