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Inspection Summary


Overall summary & rating

Good

Updated 18 May 2018

This inspection took place on 28 March 2018. We gave the provider two days’ notice of the inspection as we needed to make sure the manager and staff would be available at the location. This service is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service mainly to older adults. Not everyone using Home Healthcare receives the regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

Home Healthcare is an independent care agency providing personal care support to people living in their own homes. At the time of our inspection there were approximately 21 people using the service. The service had 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 2008 and associated Regulations about how the service is run.

At our last inspection of the service on 11 and 12 May 2017 we found breaches of regulations and took enforcement action serving a warning notice on the provider and registered manager, requiring them to address concerns we had identified. This was because medicines were not always managed and administered safely. Risk assessments were not detailed and did not provide guidance for staff to ensure people's safety and well-being. Staff recruitment systems were not consistently applied. Care plans and records lacked detail. Systems and processes in place to assess, monitor and improve the quality of the service were not established and operated effectively. At this inspection we found significant improvements had been made, the warning notice had been met and all required actions had been completed.

Medicines were managed and administered safely. There were safeguarding policies and procedures in place and staff knew what actions to take to protect people from harm. Risks were assessed, managed and reviewed to ensure people’s needs were safely met. Detailed guidance for staff on managing risk and needs were appropriately documented. Appropriate recruitment checks took place before staff started work and there were enough staff to meet people’s needs. There were systems in place to ensure people were protected from the risk of infections.

Assessments of people’s care and support needs were conducted and documented. Staff completed an induction when they started work and received appropriate training. Staff were aware of the importance of seeking consent and demonstrated good knowledge of the Mental Capacity Act 2005. There were arrangements in place to comply with the Mental Capacity Act 2005. People were supported to meet their nutritional needs where appropriate and people were supported to access health and social care professionals when required.

People told us staff were caring and respectful. People were consulted about their care and were provided with information about the service that met their needs. People received personalised care that met their diverse needs. People knew about the provider’s complaints procedure.

There were systems in place to assess and monitor the quality of the service provided. The provider took into account the views of people using the service and staff. There was an out of hours on call system in operation that ensured management support and advice was always available.

Inspection areas

Safe

Good

Updated 18 May 2018

The service was safe.

There were robust systems in place to ensure medicines were managed and administered safely.

Assessments were conducted to identify and assess levels of risk to people�s health and well-being. There was clear guidance for staff on managing people�s needs and risks.

There were safe and robust staff recruitment practices in place.

There was an electronic call monitoring and care planning system in place to ensure people received the care and support they required and there was enough staff to meet people�s needs.

Accidents and incidents were recorded, managed and acted on appropriately.

There were policies and procedures in place to safeguarding people from abuse and staff had a clear understanding of how to report concerns.

There were infection control policy and procedures in place to minimise the risk of infections.

Effective

Good

Updated 18 May 2018

The service was effective.

Detailed assessments of people�s needs and preferences were conducted.

People were supported to meet their nutritional needs and preference.

People were supported to access health and social care services when needed.

There were arrangements in place to comply with the Mental Capacity Act 2005.

Staff new to the service were provided with an induction when they started work and staff received on going supervision and appropriate training.

Caring

Good

Updated 18 May 2018

The service was caring.

People spoke positively about staff, the support they provided and told us they were involved in planning and reviewing their care.

People were provided with information about the service.

People told us their privacy, dignity and independence was respected.

Responsive

Good

Updated 18 May 2018

The service was responsive.

People told us they were involved in making decisions about their care that met their needs and preferences.

Care records and assessment took into account the support people may require with regard to any protected characteristics under the Equality Act 2010.

People were supported to engage in a range of community social activities that reflected their interests where this formed part of their plan of care.

People were provided with information on how to make a complaint.

Well-led

Good

Updated 18 May 2018

The service was well-led.

There was a registered manager in post. They knew the service well and were knowledgeable about the requirements of a registered manager and their responsibilities with regard to the Health and Social Care Act 2014.

There were systems in place to ensure care plans and records were appropriately maintained and care visits were conducted as planned.

Feedback from people using the service was sought through telephone monitoring and review calls and quarterly satisfaction surveys.

There were robust systems in place to assess, monitor and improve the quality of the service.