Archived: Health Care Recruiters Limited

Updated 17 June 2017

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 inspection visit took place across two dates 30 March 2017 and 12 April 2017 and it was announced. The provider was given 24 hours' notice because the location provides a domiciliary care service we needed to be sure someone would be available.

The inspection was carried out by one adult social care inspector.

Before this inspection, we looked at all the information we held about this service. We reviewed notifications of incidents that the provider had sent us. We received feedback from nurse professionals and service commissioners. Their feedback is included within this report. We also contacted Healthwatch for their views on the service.

During our inspection, we went to Health care recruiters office and spoke with the manager. We spoke with three care staff members. Due to the complexity of the needs of people supported by the service, it was not appropriate for us to visit people's homes. However, we spoke to three parents of children who used the service. This enabled us to determine if people received the care and support they needed. In addition, if any identified risks to people's health and wellbeing were being appropriately managed.

We closely examined the care records of four people who used the service. This process is called pathway tracking. It enables us to judge how well the service understands and plans to meet people's care needs and manage any risks to people's health and wellbeing.

We reviewed a variety of records, including some policies and procedures, safety and quality audits, six staff personnel and training files, records of accidents, complaints records, various service certificates and medication administration records.

Updated 17 June 2017

Health care recruiters provides staff to support families to care for children and young people and adults with complex or life threatening needs in their own homes.

We last inspected this service in July 2016; at this inspection visit, we rated the service as ‘Requires Improvement. We identified concerns around the statement of purpose, need for consent, good governance and staffing.

This inspection took place across two dates, 30 March 2017 and 12 April 2017. This inspection was announced 24 hours’ prior to the inspection. We did this as the service was small and we needed to be sure someone would be available to provide us with the information we required. At the time of our inspection, Health care recruiters provided services to four children.

There is currently no registered manager at the service. The previous registered manager de-registered in October 2016. There is a interim manager at the service. 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.

At the last inspection we found a breach of Regulation 17 Good governance of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because we found the service did not have a robust quality auditing system in place. During this inspection we reviewed the audit records and could not find documented evidence to show audits were being undertaken. This was a continued breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) 2014.

At the last inspection carried out in July 2016 we found a breach of Regulation 18, Staffing of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because staff had not received formal supervision. During this inspection we found that staff felt supported by the management and were able to make contact if they needed to. We have made a recommendation about this.

At the last inspection we found a breach of Regulation 11, Need for consent of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because care records for adults had no evidence of mental capacity assessments, or best interests decisions where needed.

During this inspection we could not check if there had been an improvement, as the service did not provide any packages of care to adults.

At the last inspection we found a breach of Regulation 12 Registration Regulations 2009 (Schedule 3) Statement of purpose. This was because the statement of purpose did not reflect the registered services they provided. During this inspection we found statement of purpose had been re-written to reflect the current services provided.

We reviewed the staff rotas and spoke with staff during this inspection. Relatives told us that the service has a lack of contingency staff to cover the care packages, and that they do not have many staff to cover the package. We reviewed the staffing and there were no missed visits.

Care records detailed when people needed care and support. This had been agreed with people, their families and other health and social care professionals. The level of detail in people's care plans was not consistent across the service; some parts had not been updated following changes in peoples care, and support needs. We have made a recommendation about this.

Care records included detailed risk assessments, which provided staff with guidance on how the risks to people were minimised. Staff responsible for the administration of medicines had been trained to administer them safely.

Care plans showed that where appropriate the service had made referrals to health care professionals.

Systems were in place to reduce people being at risk of harm and potential abuse. We found suitable recruitment processes were carried out.

Staff were provided with detailed guidance in people's care plans regarding the support people required with their nutrition.

Relatives were positive and complimentary about the care their family member received. Relatives told us privacy and dignity was promoted and respected by the staff. Staff had a good understanding of protecting and respecting people’s human rights.

People and their families told us they received personalised care which was responsive to their needs.

People were encouraged to raise any concerns or complaints. The service had a complaints procedure.

The manager and staff had a good understanding of the principles underpinning providing care in people's own homes.

Accidents, incidents, complaints and safeguarding alerts were appropriately reported by the service. The manager investigated accidents, incidents and complaints. This meant the service was able to learn from such events.

The policies and procedures we looked at were regularly reviewed. Staff we spoke with knew how to access these policies and procedures. This meant clear advice and guidance was available to staff.

Following the inspection the manager provided us with an initial action plan in order to address the concerns we found and to make improvements to the service.

You can see what action we told the provider to take at the back of the full version of the report.