Archived: Helping Hand Care Services Limited

We asked the provider to complete an action plan to show what they would do and by when to improve the key question; 'Is the service safe?', 'Is the service effective?', 'Is the service responsive?' and 'Is the service well led?' to a rating of at least good. At this inspection, we saw some areas of improvement. However, the service remained in breach of regulation 17.

Helping Hand Care Services Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and younger disabled adults. At the time of the inspection there were 35 people using the service.

There was a registered manager in post at the time of the 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.

Medication administration records were not consistently completed to demonstrate people received their medicines as required. There was no formal audit process for medicines administration records, so it was not clear that issues had been identified and actions taken.

Care plans were not always reviewed regularly, and the level of person-centred information was not always consistent, with some templates and documents left blank. Some information about how people wanted their needs met was provided. However, this was not followed up with actions for staff to take. There was no audit process in place to ensure care plans contained relevant information.

People told us they found the service safe, and there were enough staff to meet their needs. Staff had been recruited safely. There were systems and processes in place to protect vulnerable people from abuse.

Staff told us they received good standards of training and support in the form of an induction, training modules, supervisions and spot checks. People were confident that staff had the skills necessary to meet their needs.

Staff understood their role in helping people maintain a healthy lifestyle which included a good diet. People told us staff were attentive to their clinical needs and documents showed the service worked positively with other healthcare agencies.

People’s health and wellbeing was monitored effectively, with their food and fluid choices taken into account. The registered manager understood their role in upholding the principles of the Mental Capacity Act 2005, and where people had capacity to make decisions this was clearly recorded and respected.

People told us staff were kind, caring and compassionate. Staff maintained people’s independence and upheld their privacy and dignity.

There were systems and processes in place for people to raise complaints and for these complaints to be investigated appropriately. People told us they were confident they knew how to complain and issues would be addressed.

People and staff told us that senior staff were approachable and there was a positive working culture at the service. Furthermore, they would recommend the service both to work for and receive care from.

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

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and younger disabled adults.

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 and associated Regulations about how the service is run.

Medicines were not managed safely. Records of people’s medicines were not accurate or up to date. It was not therefore possible to see if people had received their medicines as prescribed. This put people’s health at risk.

The registered manager told us they used a range of systems to monitor quality and identify issues and areas for improvement at the service. However, these were not always formally recorded to demonstrate a commitment to continuous improvement of the service. For example, medication checks had not been recorded or identified the concerns we found with medicines during our inspection.

Overall, people and their relatives told us they were happy with the support they or their family member received from the service. People told us they felt safe with their care workers and the care they were provided with. They said they received a good standard of care.

There were systems and procedures in place to protect people from the risk of harm. Care workers were aware of the different types of abuse and what would constitute poor practice. Recruitment was managed safely.

Care workers understood their role and responsibilities for maintaining good standards of cleanliness and hygiene. However, some care workers needed refresher training in the prevention and control of infection to ensure their practice remained current. Care workers said they had plentiful supplies of personal protective equipment.

Training records showed care workers had completed a range of training; however records of some induction training completed was not available. Training records did not indicate the providers expected interval between refresher training. The registered manager agreed to introduce a policy regarding this to ensure staff’s practice remained up to date.

Care workers told us they received support, supervision and appraisal to help them understand how to deliver good care. However, this was not always recorded to demonstrate this had taken place.

Care workers knew to offer people choice and what to do in the event they refused care. The registered manager and care workers we spoke with had an understanding of the principles and their responsibilities in accordance with the Mental Capacity Act (MCA) 2005.

Where needed, people who used the service received support from care workers to ensure their nutritional and health needs were met. Care workers were trained to respond to emergencies and said they felt confident to do so.

Care workers showed a good knowledge of the people they supported and understood how to maintain people’s privacy and dignity. It was clear they had developed positive relationships with people and encouraged their independence.

People who used the service and their relatives were involved in planning the care and support received. Overall, care plans contained sufficient information for care workers to follow and provide the care people wanted. Regular reviews were taking place to make sure people’s current needs were responded to.

There were procedures in place for responding to people’s concerns and complaints. People told us they knew how to complain and the service was usually responsive to concerns raised. One person told us they did not feel their concerns were fully addressed. The registered manager agreed to review the issues raised by meeting with this person.

People who used the service, relatives and care workers all spoke positively of the registered manager and their commitment to the service and people who used it.

This is the first time the service has been rated Requires Improvement.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014. You can see the action we have told the provider to take at the end of this report.

People who used the service were involved in making decisions about their care and were given opportunities to talk about how they wanted their care delivered.

Appropriate arrangements were in place in relation to management of medicines. The provider had clear guidance that outlined how medicines should be obtained and protocols that staff must follow. Staff we spoke with said they had received medication training.

People received consistent care and support that met their needs. People who used the service and their relatives told us there were enough staff with the right skills and experience to meet their needs. They said staff arrived on time and stayed the agreed length of time. One person said, 'They are marvellous, very helpful and thoughtful. A relative said, 'They are wonderful timekeepers.'

The provider had an effective system to regularly assess and monitor the quality of the service that people received. Staff we spoke with said people received safe quality care. One member of staff said, 'They run the service very well and make sure everything is checked out properly. They are great to work for."