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HG Care Services Limited Good

Inspection Summary


Overall summary & rating

Good

Updated 1 January 2019

We carried out an announced inspection of HG Care Services Limited on 22, 23 and 25 October 2018. HG Care Services Limited is a domiciliary care service and provides twenty-four-hour domiciliary care and support to adults and children in their own home. The service’s office is located on Stockport Road, Levenshulme, Manchester. At the time of our inspection, the service offered support to 326 people and employed 145 members of care staff.

At our last inspection of this service in October and November 2017 we found two breaches of regulations; these were Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, safe care and treatment and Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, good governance.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of Safe and Well-Led to at least good, which we received. At this inspection although the process of governance and oversight of the service had improved we have made a recommendation for improving the process of auditing.

Not everyone using HG Care Service Limited receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

Medicines were not consistently administered in a safe way. At this this inspection, we found the management of people’s medicines had improved, however we saw some gaps in staff signatures in one person’s medication administration records (MAR’s) who we visited at home. We determined medicines had been given as prescribed but these were not consistently recorded in the MAR charts we saw.

For another person who we visited we found their lunchtime medicines, which were due two days after our visit, had been popped out of the medicines pack and then placed back into it with cotton wool; we could not determine if the person had done this themselves but there was no clear record that this had been communicated back to the office. We also found additional sachets of a laxative medicine for this person on the floor of their house, but there were no clear records in the MAR’s or communication sheets to confirm why this was the case.

Although medicines were audited and staff were subject to observations of practice and spot checks these interventions had failed to identify the issues we found during the inspection regarding the safe management of medicines.We have made a recommendation about the management of people’s medicines and the frequency of associated auditing systems.

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 we spoke with felt they were safe when receiving support from HG Care Services and knew what to do if they were not happy about care and services. Staff could describe to us how they endeavoured to keep people safe.

Suitable safeguarding procedures were in place, which were designed to protect vulnerable people from abuse and the risk of abuse.

People had risk assessments in place which included areas such as the environment, medication and moving and handling. These provided guidance to staff as to what action to take and were regularly reviewed by the service.

People's needs were assessed in sufficient detail to inform the delivery of care by staff who supported them.

An external company was used to undertake checks and maintain the fire extinguishers, fire alarm system, emergency lighting and smoke detectors to ensure the safety of the office ba

Inspection areas

Safe

Good

Updated 1 January 2019

The service was safe.

Accurate records regarding the safe management of medicines were present in most of the MARs examined.

People told us they felt safe when being supported by the service.

There were sufficient numbers of staff on duty to meet people�s needs.

Effective

Good

Updated 1 January 2019

The service was effective.

People we spoke with felt care staff were competent.

Staff told us they received an induction and on-going training to ensure they had the necessary skills to meet people's individual needs.

Staff we spoke with confirmed they received regular one-to-one and group supervision.

Caring

Good

Updated 1 January 2019

The service was caring.

People who used the service and their relatives said they were treated with kindness and care and comments we received about the service were mostly complimentary.

We found the service aimed to embed equality and human rights through the process of person-centred care planning.

People were encouraged to express their views and to be involved, where possible, in making decisions about their care and treatment.

Responsive

Good

Updated 1 January 2019

The service was responsive.

People we spoke with who used the service and their relatives confirmed that they were involved in planning their care.

Visits to people�s homes were not rushed and all people we spoke with confirmed this was the case.

We saw that people's care plans and needs were regularly reviewed which was completed with the involvement of people and their relatives, where possible.

Well-led

Requires improvement

Updated 1 January 2019

The service was not consistently well-led.

Audits which were carried out regularly had not identified the concerns we found during the inspection in relation to medicines, staff recruitment and care plan reviews.

Staff felt the service was well-led and told us the registered manager and other managers supported them well.

People were asked for their views about the service.