Archived: Harmony Domiciliary Care (West Wickham)

Updated 7 October 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 11 August 2015 and was announced. We told the provider two days before our visit that we would be coming. We did this because we needed to be sure that the manager would be in when we inspected.

The inspection team consisted of one inspector and another inspector helped carry out phone calls with relatives and staff. Before our inspection we reviewed the information we held about the service which included any enquiries. During our inspection we spoke with the registered manager and two staff . We were not able to speak with people who used the service directly as they were not able to communicate their views and so we spoke with their relatives by phone. We looked at two support plans and five staff files as well as records related to the running of the service such as the service guide, staff guide and policies and procedures.

Updated 7 October 2015

This inspection took place on 18 August 2015 and was announced. We told the provider two days before our visit that we would be coming as we wanted to make sure the registered manager would be available. This was the first inspection of this service.

Harmony Domiciliary Care ( West Wickham) currently provides support and personal care to two people in their own homes. The service was registered in October 2014 but only started to deliver packages of care for people who pay privately at the end of March 2015.

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.

We were not able to speak with people who used the service directly as they were unable to communicate their views, and so we spoke with their relatives by phone. Relatives told us they felt their family members were safe and well cared for. People were supported by a small team of live in care workers and this helped maintain consistency and familiarity in the support provided and enabled staff to get to know people well.

However, we found breaches of regulations in respect of managing medicines as competency checks were not in place in line with the provider’s policy to ensure staff had the necessary skills to administer medicines safely. This was a breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider had also not made suitable arrangements for staff to refresh their training and keep their skills up to date or to be offered other relevant training so that the staff would be skilled to meet a wide range of needs. This was a breach of regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we have asked the provider to take in respect of both these breaches at the back of the full version of the report.

Staff were aware of how to raise any concerns and had received training on safeguarding adults so they knew the signs of possible abuse. Possible risks to people were identified and plans were put into place to reduce risk. There were arrangements to deal with emergencies and staff had first aid and fire safety training. People were supported to take their medicines when needed.

Relatives described staff as kind and caring. Staff consulted people and asked their consent before they provided care; where people lacked capacity to make a decision they were aware of the need to consult with relatives and consider how to act in their best interests. However staff knowledge was not always clear and they told us they would benefit from further training. People were asked about their food and drink choices and staff supported them with their meals and with any dietary needs. People or their relatives where applicable, were involved in making decisions about their care and support and people were supported to be as independent as they could. Care plans were responsive to people’s needs and guided staff on the care and support to be provided. People knew how to make a complaint if they needed to.

Relatives and staff told us the service was well led and the registered manager was approachable and supportive. There was room for some improvement because where areas for improvement such as staff training had been identified action had not always been taken to resolve the issue. The manager maintained close contact with people and their relatives and sought their views about the service through visits and phone calls.