Home Support Services (Havering & Essex) Limited

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults. On the day of our inspection there were 160 people using the service in the London boroughs of Havering and Essex.

On the day of our visit we met the two registered managers. 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.

Medicines were administered safely with the exception of the recording of topical creams and medicines in blister packs. We recommended that best practice guidelines were followed.

People told us they were happy with the care they received. They told us they were treated with dignity and respect by staff who were polite and kind.

Staff were aware of the safeguarding guidelines in place and knew the steps to take to record any abuse.

Risks to people were assessed with clear actions to take to reduce the identified risks. These were known and understood by staff.

Infection control guidelines were followed in order to keep people clean and minimise the spread of infection.

People told us there were enough staff to meet their needs which was confirmed in the rotas and records we reviewed.

There were robust recruitment checks in place, which ensured only staff that had been assessed as suitable to work with vulnerable people were employed. Staff were supported by regular spot checks, supervisions and annual appraisal. They attended training in various subjects in order to perform their roles effectively.

People were supported to maintain a balanced diet that met their individual preferences. They were supported to access healthcare services in order to enable them to maintain their health.

Most care plans were person centred and were reviewed regularly together with people and their relatives. We made a recommendation to ensure all aspects of care plans were person centred as aspects such as food preferences and daily routines were not always included.

There was an effective complaints process, which was understood by people and staff. People told us they were able to raise concerns and that the management followed up any concerns with the aim to resolve them satisfactorily.

People and their relatives and staff thought the service was managed well and that there was always someone available over the phone whenever they needed assistance.

The quality of care delivered was monitored through audits spot checks and surveys and action was taken to ensure people’s views were listened to.

Home Support Services provides personal care to people in the London borough of Havering and in some parts of Essex. On the day of our visit, there were over 150 people using the service, 129 of whom were partly or wholly funded by the local authority and 38 people were contributing towards their care using direct payments or a personal budget. Another two people’s care was funded by the NHS. They also provide an emergency weekend service for The London Borough of Havering, until the commissioning department finds a permanent provider to continue the care.

There were two registered managers in place. 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 told us that they felt safe and were happy with the staff that delivered their care. They told us that they were treated with dignity and respect. Care was assessed and planned with people and their families. Care plans were detailed and included people’s wishes, hopes and aspirations.

There were procedures in place to keep people safe. Staff were aware of the different types of abuse and told us that they would report any allegations of abuse to the registered manager, who in turn reported it to the local safeguarding team. Staff were aware of the procedure to take if a person did not respond to a call and if they found a person unresponsive. They told us they would stay with the person until an ambulance came.

Medicines were managed safely by staff who had been trained and were aware of the necessary precautions to take to ensure medicines were administered safely.

Risks to the environment, such as trip hazards and gas safety were completed when required to ensure that the environment was safe for people. Regular checks on equipment were made to ensure that it was safe to use.

Recruitment checks were completed before staff started employment in order to ensure that staff were qualified and suitable to work in a health and social care environment. However, disclosure and barring checks were not always refreshed once people were employed which was not in line with the service’s policy of refreshing them every three years.

Staff told us that they were satisfied with the training and support they received. This included a comprehensive induction when they first started and regular spot checks and supervisions to ensure any areas for development were discussed and a development plan agreed.

People were supported to eat sufficient amounts that met their individual, religious and cultural preferences. Staff were aware of people’s diverse needs and told us they always ensured people’s wishes were respected.

We reviewed complaints made and found they were investigated and resolved to people’s satisfaction where possible. People told us they were able to express their views without being victimised. People and staff were asked for their views regularly and any suggestions or comments made were taken into account where possible in order to improve people‘s experience.

Staff were aware of their roles and responsibilities and told us they were supported by the care coordinators and the registered manager. However, we had not received any notifications of incidents that affect the service as required by law. The management retrospectively notified us of safeguarding incidents which had already been dealt with by the local safeguarding team.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and another breach of the Care Quality Commission (Registration) Regulations 2009. You can see what action we have told the provider to take at the back of the full version of this report.