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Home Angels Healthcare Services Ltd Requires improvement

Reports


Inspection carried out on 6 November 2020

During an inspection looking at part of the service

About the service

Home Angels Healthcare Services Ltd is a care agency which provides staff to support people in their own homes. People with various care needs can use this service including people with physical disabilities and older people. At the time of this inspection 10 people received personal care from this service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating.

People’s experience of using this service and what we found

The provider did not ensure systems were in place to oversee the service and ensure compliance with the fundamental standards. The registered person did not always ensure they maintained clear and consistent records. They did not ensure the Care Quality Commission (CQC) was informed of notifiable incidents in a timely manner.

Medicines were not always handled and recorded correctly and safely. Complaints were not managed effectively and not according to the provider’s policy. The prover ensured their safeguarding systems were operated effectively to investigate and follow the provider's policy and procedure after becoming aware of allegations of abuse, neglect or acts of omission. They did not have evidence to support the effective process. The provider did not ensure risks to people’s personal safety had been assessed and that care plans were in place to minimise those risks.

There was a mixture of feedback about how staff felt regarding the provider support, accessibility, and the management of the service. Staff did not feel they could ask the management for help when needed at times. Staff felt the management was not always open with them and did not communicate what was happening in the service.

People received care and support that was personalised to meet their individual needs. People's diverse needs were identified and met and their right to confidentiality was protected.

There were contingency plans in place to respond to emergencies. The provider had started seeking feedback from people and families, which they would use to make improvements to the service and protected people against the risks of receiving unsafe and inappropriate care and treatment.

Staff recruitment has been improved and we saw changes made to the recruitment and selection process.

At the last inspection we made a recommendation that future ongoing staff training and monitoring of practice is updated in line with the latest best practice guidelines for social care staff. We saw training has been improved. However, we noted to the provider there was no effective system in place to oversee it and ensure staff remained knowledgeable and competent to support people who use the service.

Staff felt they could visit people on time and stay the right time. The visits were scheduled using online system and overseen by the care coordinator. People and relatives felt the staff supported them well however some improvements could be made such as timings and consistencies of the visits.

People reported they felt safe with the staff providing their support and care. Relatives agreed they had no issues with people’s safety. Staff understood their responsibilities to raise concerns and report incidents or allegations of abuse. The staff team followed procedures and practices to control the spread of infection using personal protective equipment. People and their relatives who provided feedback said people were treated with care, respect, and kindness by the staff visiting them.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 10 January 2020).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection not enough improvement had been made and sustained, and the provider was

Inspection carried out on 20 November 2019

During a routine inspection

About the service

Home Angels Healthcare Services Ltd is a care agency which provides staff to support people in their own homes. People with various care needs can use this service including people with physical disabilities and older people. At the time of this inspection 25 people received care from this service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

The registered person did not ensure systems were in place to oversee the service and ensure compliance with the fundamental standards. The registered person did not always ensure they maintained clear and consistent records. They did not ensure Care Quality Commission was informed of notifiable incidents in a timely manner.

Staff recruitment and staff deployment did not always support people to remain safe in their own homes. The way visits were scheduled, the staff felt they were not always able to support people appropriately and in good time. People were not always informed about the changes to their visits or staff, as necessary. Medicines were not always handled and recorded correctly and safely.

We made a recommendation that future ongoing staff training and monitoring of practice is updated in line with the latest best practice guidelines for social care staff. Staff said they did not always feel supported to do their job or ask the management for help when needed.

There had been management changes since the last inspection, which affected the service and staff team. The new registered person had reviewed paperwork, systems and processes to ensure they could assess and monitor the quality of care in a more consistent way. There was some progress in making various improvements but not sufficient at the time of the inspection for us to judge this would be sustained.

There was a mixture of feedback about how staff felt in regard to the management support, accessibility, and the management of the service. Staff felt the management was not always open with them and did not communicate what was happening in the service. People and relatives also felt the service was not managed consistently and some improvements could be made.

People and their relatives who provided feedback said people were treated with care, respect, kindness and their dignity were upheld by most of the staff visiting them. People were involved in review of their care and support and could change how things were done if they wanted to. People received care and support that was personalised to meet their individual needs. People's diverse needs were identified and met and their right to confidentiality was protected.

People were protected from the risks of abuse and said they felt safe with the staff providing their support and care. Relatives agreed they had no issues with people’s safety. Staff understood their responsibilities to raise concerns and report incidents or allegations of abuse. The staff team followed procedures and practices to control the spread of infection using personal protective equipment. There were contingency plans in place to respond to emergencies. The registered person had the knowledge to identify safeguarding concerns and acted on these appropriately. Risks to people’s personal safety had been assessed and care plans were in place to minimise those risks.

People were supported to access healthcare professionals such as their GP. The service worked with other health and social care professionals to provide support and care for people. People were supported to eat and drink to meet their nutrition and hydration needs according to their care plan.

People's rights to make their own decisions were protected. People were supported to have maximum choice and control of their lives and staff supported them in the leas

Inspection carried out on 29 November 2016

During a routine inspection

This inspection took place on the 29 November and was announced.

Home Angels Healthcare Ltd is a care agency which provides staff to support people in their own homes. People with various care needs can use this service including people with physical disabilities and older people. At the time of this inspection 39 people received care from this service.

The service had a registered manager. 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 and their relatives told us that they felt safe with staff and would be confident to raise any concerns they had. The provider’s recruitment procedures were thorough and medicines were managed safely. There were sufficient staff to provide safe, effective care at the times agreed by the people who were using the service.

There were procedures in place to manage risks to people and staff. Staff were aware of how to deal with emergency situations and knew how to keep people safe by reporting concerns promptly through processes that they understood well.

Staff received an induction and spent time working with experienced members of staff before working alone with people. Staff were supported to receive the training and development they needed to care for and support people’s individual needs.

People and their families were mostly complementary of the services provided. An improvement in the timings of calls was reported by people and their relatives. The comments we received demonstrated that the majority of people felt valued and listened to. People were treated with kindness and respect whilst their independence was promoted within their homes and the community. People received care and support from familiar and regular staff most of the time and some would recommend the service to other people.

People’s needs were reviewed and their care and support plans promoted person-centred care. Up to date information was communicated to the majority staff to ensure they could provide the appropriate care and support for each individual. Staff knew how to contact healthcare professionals in a timely manner if there were concerns about a person’s wellbeing.

The provider had a system to regularly assess and monitor the quality of service that people received and identified areas for improvement.