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Helping Hand Care Services Limited Requires improvement

Reports


Inspection carried out on 11 January 2019

During a routine inspection

This inspection took place on 11 and 14 January 2019 and was announced. At the last inspection, in January 2018 we found two breaches of the regulations, Regulation 12 (Safe Care and Treatment) and Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection the service continued to breach Regulation 17 and remained ‘requires improvement’ overall.

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.

Inspection carried out on 15 November 2017

During a routine inspection

This was an announced inspection carried out on 15, 16, 20 and 30 November 2017. At the last inspection in September 2015 we found the provider met the regulations we looked at.

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 wer

Inspection carried out on To Be Confirmed

During a routine inspection

This inspection took place on 29 September 2015 and was announced. At the last inspection in August 2013 we found the provider was meeting the regulations we looked at.

Helping Hand Care Services Limited provides care and support to people in Leeds and surrounding areas. The agency's office is situated in Chapel Allerton which is on the outskirts of Leeds. They offer a range of services to individuals who live in their own homes and need support or care.

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.

People we spoke with told us they were very happy with the care they received from the service.

People who used the service told us they felt safe with the staff and the care they were provided with. We found there were systems in place to protect people from risk of harm and appropriate recruitment procedures were in place. There were policies and procedures in place in relation to the Mental Capacity Act 2005 and staff showed they understood how to ensure their practice was in line with the MCA.

We found people were cared for, or supported by, appropriately trained staff. Staff received support to help them understand how to deliver good care. People who used the service said their visit times suited their wishes and staff always stayed the agreed length of time.

Systems were in place to monitor the quality and safety of service provision and we found there were appropriate systems in place for the management of complaints.

People told us they got the support they needed with meals and healthcare. We saw arrangements for medication were safe.

Inspection carried out on 9 April 2013

During a routine inspection

We spoke with five people who used the service or their relative. They said they were happy with the care and support they received. One person said, “They always get me ready the way I like and do it well.” A relative said, “We get nice continuity, the same people at regular times. It works a treat.”

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."

Inspection carried out on 3 May 2012

During a routine inspection

People who use the service and their representatives told us they were happy with the care and support they received. They made the following comments:

“I’m very happy and know all the staff. Any new carers are always introduced and come to see me before working with me.”

“Staff are very polite. It’s more like a family. They will do the extra bits and that’s important.”

“I really must praise the staff, all of them are very good and know what to do.”

“Before the carers go on their way they check I’m happy with everything.”

“The manager often comes out. We’ve never had cause to complain but if we did I would never have a problem raising it.”

“The manager is very involved and provides good support to everyone.”

People who use the service, their representatives and staff said the quality of the service was good. Most people told us they didn’t think the service could improve. Some people said the agency had been very busy and thought some things could have been better organised. One person said, “It’s been a hard year but hopefully the recruitment of new staff should help.” Another person said, “They are doing well with what they are doing but some aspects could be better.”

Staff we spoke with told us that people received appropriate and safe care. Staff said they knew the people they were supporting well. They said they had good systems in place to make sure people’s rights, choices and independence were promoted. One member of staff said, “People are getting a good service; it’s definitely about quality and what people want.” Another member of staff said, “They are big on quality and want to provide people with the best.”

Inspection carried out on 24 January 2011

During a routine inspection

People who use the service and their carers told us they are happy with the service they receive and staff are respectful and good at promoting independence. Everyone we spoke to said they were involved in making decisions about their care, and the care they receive is appropriate and meets their needs. People who use the service and their carers made the following comments;

• I was involved in planning and decided what I want and then they went through the care plan with me.

• The manager did the assessment with (name of person receiving a service). He did a long interview. We are confident with the service we are getting and are fortunate. It’s a very good care service.

• When I started using the service they knew what I wanted. There were no ifs and buts, they provided it and it suits me perfectly.

• At first I needed a lot of help, now I can do more. I am very pleased with what they do. The staff always do what I ask them to do.

• They are pretty hot with medication and make a record when they prompt.

• They are all competent and capable and know how to use hoisting equipment.

• They are choosy about who they employ.

• The same staff visit so the care is consistent and you build up a relationship with them.

• Times for visits are always good. If I have an appointment I ask for an earlier time and they are spot on.

• I get the same care workers and we get on very well. Timings are very good.

• Staff are very nice and always do what I ask them to do, and more.

• We are very satisfied with the service, very happy with them. We previously used a different agency but this is a much better quality service.

• We are confident with the service we are getting and are fortunate. It’s a very good care service.

• We have had no concerns but if we did there would be no difficulty talking to them.

• If anything was wrong the manager would always put it right.

• The records are good, we look at what they have written and they always record times they have visited and what they have done during the visit such as what they have cooked.

• He (the manager) is very helpful, very considerate, he understands needs. I see him regularly, if he is passing he calls to check everything is ok. He’s very good.

• The manager is brilliant and always shows respect.

Staff told us that people receive a very good service, which is very well managed and the care is always centred around what people want. Staff told us good systems are in place to make sure they are trained and well supported. Staff made the following comments;

• We make sure we ask people what they want, give choice and remember we are visiting people in their home.

• The service is very good, especially promoting privacy, dignity and independence.

• The manager is very knowledgeable, very well organised, experienced and understands it from the customer. He knows what he is doing. People get what care they want at the times they want it.

• Support plans tell us all about the person, what we need to do and what they like.

• It’s a really good person centred company.

• Communication with other professionals is good. We have contact numbers in support plans and will ring if we need to follow anything up.

• At my interview, the management team asked me different questions and discussed what the agency expects from care workers. They said it’s not just about popping in and out, we want staff to talk to people and do things properly.

• We always have enough time for our visits. If we are running late for any reason we wouldn’t rush but we’d ring and explain to the next person that we are running late.

• Timing is good, well planned and you don’t have to rush. It’s well organised. Staff don’t get stressed.

• The manager said they do 30 minute minimum visits because anything less does not give care workers enough time to greet the person, carry out the tasks to meet their needs and check they are ok before leaving.

• It’s a good team, always there for support, it feels secure. We regularly work alongside the manager so he knows how we work. He will always go out of his way to help and we feel supported. It’s a good service and people get good quality care

• It's a really enjoyable company to work for.

• We have regular supervision and are listened to. We discuss quality, put forward ideas. It’s a good open forum.