Extra Hands of Heacham Limited - Heacham Office

Extra Hands of Heacham Limited – Heacham Office is a service providing care and support to people in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our inspection the service was providing personal care to 113 people.

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

Overall medicines were managed safely, however, there were some areas of medicines management which needed further development and improvement. We have made a recommendation about the management of medicines which are only occasionally required (PRN.)

People told us they felt safe. Staff were clear about their safeguarding responsibilities. Risks and infection control procedures were managed well and kept under review. There were enough staff and people told us they could rely on the service. Recently some calls had not run on time, but this was a resolving situation and had had no major impact on people’s care.

People’s needs were comprehensively assessed before a service was provided. Staff were well trained and had been recruited safely. The service worked well with other health and social care agencies.

People consented to their care and treatment and this was recorded. 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.

People received care and support from kind, patient and caring staff who often went the extra mile for them. People’s dignity and privacy was upheld. They were encouraged to express their views about their care and treatment and the provider respected these.

People received a person-centred service which considered their care needs holistically. Complaints were well managed and lessons learned where necessary. Information about people’s end of life care preferences was basic. However, the provider has designed a survey to capture more detail, should people wish to share this.

Recent management changes had identified that oversight of some aspects of the service needed improving and immediate action was taken. The provider had a clear vision for the future of the service and new measures, such as the new electronic care recording system have been introduced. This had improved communication and saved staff time.

People who used the service and staff were keen to share very positive feedback with us about the quality of the service. We have confidence that this provider will attend to the minor issues we have raised and continue to make further improvements.

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

Rating at last inspection

The last rating for this service was outstanding (published 13 April 2019.)

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.

People’s experience of using this service:

The service had strong leadership and a well- planned and organised workforce. This ensured people had consistency from a small team of care staff who knew their needs well and could be relied upon. Care calls were electronically monitored to ensure people received a need based service. There were emergency plans in place to ensure all calls were covered or extra ones could be provided when required. The service had a rapid response team who were not scheduled to cover calls and meant they could respond to people’s changing needs and able to avert a crisis or take some of the strain of a family member. For example, when a family member had an admission to hospital.

Staff recruitment procedures were robust and helped ensure only suitable staff were employed. The service invested heavily in its staff and ensured they were well trained, competent and shared the organisation values and upheld the rights and dignity of people they were supporting. This helped to promote staff retention and there were processes in place to support and develop staff

The service had robust systems in place to monitor the safety and quality of the service they provided. They clearly communicated their high expectations of their service and their staff and took responsibility and accountability for when things went wrong. They learnt from their mistakes and used them to embed and change procedures to ensure sufficient safeguards were in place. They considered best practice and current guidance. Care was planned to take into account new technologies and current risks within the market place.

The service contributed to new ways of working and were part of steering groups looking at policy change. They worked collaboratively with other organisations to help improve outcome for people they were supporting and be an equal contributor in the care sector.

The care was personalised and flexible according to people’s assessed needs and wishes.

Staff were kind and compassionate and this was an inclusive service which looked after people well, their extended families and the staff providing the care. Good practice was recognised and rewarded as a way of supporting and motivating care staff and helping them feel valued.

The service was seamless with staff at all levels understanding their responsibility to provide good care and safeguard people. There were systems in place to learn lessons when things went wrong and to reflect on practice to identify any shortfalls or come up with new initiatives which would help improve the service.

The service had been compliant since registration and has retained a good rating. There was an inclusive team. The service demonstrated its commitment to high quality care through its membership with investors for people, its engagement with the community and its presence at care award ceremonies. It had reached the finals consecutively over many years and contributed to raising the standards in care.

Rating at last inspection: (Good). The report was published 27 July 2016

Why we inspected: This was a scheduled inspection based on our previous rating.

Follow up: ongoing monitoring; possibly more about how we will follow up

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

The service had a registered manager in place at the time of our inspection. 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 were supported by staff who understood the risks people could face and knew how to make people feel safe. People were encouraged to be independent and risks were mitigated in the least restrictive way possible.

People were supported by a regular staff member or group of staff who they knew. People who required support to take their medicines received assistance to do so when this was needed.

People were provided with the care and support they required by staff who were trained and supported to do so. People’s human rights to make decisions for themselves were respected and they provided consent to their care when needed.

People were supported to consume a sufficient amount of food and fluids that promoted their wellbeing. People received support from staff who understood their health needs.

People were treated with respect by staff who demonstrated kindness and understanding. People were involved in determining their care and support. They were shown respect and treated with dignity in the way they wished to be.

People could not rely on their plan of care containing all the required information to ensure their care and support was delivered as needed. People’s concerns may not be recognised and acted upon.

The management team provided leadership that gained the respect of care workers and motivated them as a team. When issues were indented within the service action was taken to address these. There were systems in place to monitor the quality of the service and make improvements when needed.

People who used the service and family members of other people who used the service, had positive comments to make about the standard and quality of the support and care provided. Support and care provided maintained and promoted people's health, safety and wellbeing.

Effective systems were in place to safely support people with the management of their medication, if this was needed.

Although staff had distances to travel between call visits, people said that members of staff generally had arrived on time and when there call visit was due to start. This indicated that there were sufficient numbers of staff to meet people's support and care needs in a timely manner.

People said that remedial action had been taken in response to their concerns or complaints. They said that this had improved the standard and quality of their support and care. Some also said that they were actively asked for their views about their support and care and action had been taken, if needed.