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Harmony Homecare Limited - 164 Birchfield Road East Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 22 August 2019

About the service

Harmony Homecare Limited – 164 Birchfield Road East, referred to within this report as Harmony Homecare, is a domiciliary care agency providing personal care to older people in their own homes. At the time of inspection, the service was supporting 49 people. 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.

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

People told us they experienced care that met their needs and they were treated well by the staff. However, we identified a number of concerns that required improvement and had the potential to put people at risk of harm.

People’s medicines were not adequately recorded. We found medication administration records were inconsistently completed and did not reflect how people’s medicines should be administered. People’s risk assessments did not always cover all of people’s known risks, for example risks associated with people’s healthcare conditions, or how staff could minimise those risks. The provider’s safeguarding systems did not promptly minimise risks for other people following safeguarding incidents.

Improvements were required to ensure staff worked effectively with other agencies involved in people’s care needs, for example other healthcare services and equipment suppliers.

Staff had not received appropriate training to meet the needs of people using the service. At the last inspection we had identified improvements were required to the training of staff however insufficient progress had been made in this area.

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. However, the policies and systems in the service did not always support this practice.

Care plans were not sufficiently reviewed and updated. For example, for a nutritional assessment the provider had guessed people’s weight. This left people vulnerable to inappropriate care being delivered to them.

Significant improvements were needed to the providers understanding of the responsibilities of being a good care provider. Some audits were in place however, they failed to effectively identify and act on the required areas for improvements. The provider had failed to learn and take action from the previous inspection and this put people at risk of receiving unsafe care.

People were positive about the approach of staff and felt the staff were kind. They also gave positive feedback about the approachability of the provider however we found the provider had not always resolved concerns and feedback in a timely way.

We have made two recommendations for the provider to establish better working links with other agencies involved in people’s care, and for the provider to understand the duty of candour responsibilities.

Rating at last inspection

The last rating for this service was requires improvement (published 28 July October 2018). The service remains rated requires improvement. This service has been rated requires improvement for two consecutive inspections including this one.

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well-led sections of this full report.

The provider has taken some action to mitigate the risks to people however we have been unable to review if this has been effective. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches in relation to how medicines are managed and the insufficient governance systems that are in place.

Please see the action we have told the provider to take at the end of this report.

Follow up

We

Inspection areas

Safe

Requires improvement

Updated 22 August 2019

The service was not always safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 22 August 2019

The service was not always effective.

Details are in our effective findings below.

Caring

Good

Updated 22 August 2019

The service was caring.

Details are in our caring findings below.

Responsive

Requires improvement

Updated 22 August 2019

The service was not always responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 22 August 2019

The service was not always well-led.

Details are in our well-led findings below.