Archived: HLC Care Agency Ltd

HLC Care Agency is a small family run domiciliary care agency which provides personal care and support for people living in their own homes. At the time of the inspection the service was providing personal care to 13 people.

There was a registered manager at the service. The registered manager was also the provider. 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.

At our previous inspection on 05 July 2016, we found breaches of Regulation 17, Regulation 18 and Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider had failed to operate an effective quality assurance system and failed to maintain accurate records. The provider had not ensured that staff received appropriate training and professional development to meet people's needs. They had not provided appropriate support, supervision and appraisal as is necessary to enable staff to carry out the duties they were employed to perform. The provider failed to follow established recruitment procedures effectively.

The provider sent us an action plan on 28 July 2016 which showed they planned to make the changes and meet regulations by 20 October 2016.

The provider had suitable processes in place to safeguard people from different forms of abuse. Staff had been trained in safeguarding people and in the provider’s whistleblowing policy. They were confident that they could raise any matters of concern with the provider, or the local authority safeguarding team.

The provider provided sufficient numbers of staff to meet people’s needs and provide a flexible service.

The provider had robust recruitment practices in place. Applicants were assessed as suitable for their job roles. Refresher training was provided at regular intervals.

All staff received induction training which included essential subjects such as maintaining confidentiality, moving and handling, safeguarding adults and infection control. They worked alongside experienced staff and had their competency assessed before they were allowed to work on their own.

Procedures, training and guidance in relation to the Mental Capacity Act 2005 (MCA) were in place which included steps that staff should take to comply with legal requirements.

The provider carried out risk assessments when they visited people for the first time. Other assessments identified people’s specific health and care needs, their mental health needs, medicines management, and any equipment needed. Care was planned and agreed between the provider and the individual person concerned. Some people were supported by their family members to discuss their care needs, if this was their choice to do so.

People were supported with meal planning, preparation, eating and drinking. Staff supported people, by contacting the office to alert the provider to any identified health needs so that their doctor or nurse could be informed.

People said that they knew they could contact the provider at any time, and they felt confident about raising any concerns or other issues. The provider carried out spot checks to assess care staff’s work and procedures, with people’s prior agreement. This enabled people to get to know the provider.

Staff had received regular individual one to one supervision meetings and appraisals as specified in the provider’s policy.

Effective systems were in place to assess and monitor the quality of the service. There were formal checks in place to ensure that all records were up to date. Care plans and assessments had been consistently reviewed.

People spoke positively about the way the service was run. The management team and staff understood their respective roles and responsibilities. Staff told us that the provider was approachable and understanding.

HLC Care Agency is a small family run domiciliary care agency which provides personal care and support for people living in their own homes. At the time of the inspection the service was providing personal care to 23 people.

There was a registered manager at the service. The registered manager was also the provider. 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.

The agency did not have suitable processes in place to safeguard people from different forms of abuse. Although staff had been trained in safeguarding people, they could not explain what safeguarding is about. They could not tell us what whistleblowing is about. The Kent and Medway local authority safeguarding policy, protocols and guidance was dated 2010. This meant that staff did not have up to date information and relevant local guidance on how to recognise and protect people from abuse. We have made a recommendation about this.

There were no robust recruitment practices in place. Applicants were assessed as suitable for their job roles. However, there were gaps in recruitment records. Only one reference was found in some staff files.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. There were procedures in place and guidance was clear in relation to Mental Capacity Act 2005 (MCA) that included steps that staff should take to comply with legal requirements. However, all staff had not received training in the Mental Capacity Act 2005. Staff were not able to tell us anything about the Act or its principles, and how it affected their practice. Staff did not have an awareness of Deprivation of Liberty Safeguards. We have made a recommendation about this.

Staff had not received regular individual one to one supervision meetings and appraisals as specified in the provider’s policy.

Effective systems were not in place to assess and monitor the quality of the service. There were no formal checks in place to ensure that all records were up to date. Care plans and assessments had not been consistently reviewed.

The agency provided sufficient numbers of staff to meet people’s needs and provide a flexible service.

People were supported with meal planning, preparation and eating and drinking.

People said that they knew they could contact the provider at any time, and they felt confident about raising any concerns or other issues.

People spoke positively about the way the agency was run. The management team and staff understood their respective roles and responsibilities. Staff told us that the registered manager was very approachable and understanding.

During this inspection, we found breaches of regulations relating to fundamental standards of care. You can see what action we told the provider to take at the back of the full version of this report.

People told us they were treated well by the staff and one person said, 'The staff are all friendly and treat me very well. I get on well with everyone and they make me feel comfortable.'

One relative told us, 'We were involved in planning and agreeing the care plan for my relative and we have been pleased with the service provided.'

People who used the service told us that they knew how to make a complaint about the service they received; one person told us, 'I know about the complaints procedure, I have been told about it, but I have never needed to use it.'

The staff we spoke with demonstrated a good knowledge of the providers safeguarding procedures and policies, and told us that they knew how to recognise and report suspected abuse.

Staff told us they were supported through supervision and regular staff meetings and that this enabled them to provide a good quality service to the people who used the service.

The people who used the service were complimentary about the provider, the quality of care they received and the professionalism of care staff. One person told us, 'I am very happy with the service I receive. I have had the same carer for well over a year and they are able to support my needs.'

Staff we spoke to told us that they received regular supervision, people said they felt that the training programme enabled them to carry out their role competently and that the management team was supportive and accessible.

People who used the service told us that they were very happy with the care and support that they received, staff were reliable, supportive and flexible and they were treated with respect and dignity. One person said " things are going well, the staff are reliable and they let me know if they are going to be late. They listen to me and respect my wishes."