Background to this inspection
Updated
11 May 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.
This comprehensive inspection took place on 16 March 2018 and was announced. We gave the service 24 hours’ notice of the inspection visit because we needed to be sure the registered manager would be available.
Before the inspection, we reviewed information we held about the service, which included notifications they had sent us. A notification is information about important events, which the provider is required to send us by law. We also contacted Local Authority commissioners of adult social care services and Healthwatch and asked them for their views of the service provided.
We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.
Inspection site visit activity took place on 16 March 2018. We visited the office location to see the registered manager and office staff and to speak with care staff.
The inspection team consisted of an inspector and two Expert by Experiences. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. They carried out the telephone interviews with people prior to the office-based inspection. They spoke with 28 people who used the service and 11 relatives.
The inspection was informed by feedback from the telephone interviews as well as questionnaires completed by a number of people using service, relatives, staff and community professionals. We sent 150 questionnaires out and received 39 responses. These responses highlighted people received good quality care from kind and caring staff, although some people felt communication with the office-based staff could be improved.
During the inspection, we spoke with four members of the care staff, quality partner, registered manager, the new manager and regional head of home care.
We looked at records relating to six people who used the service as well as three staff recruitment records. We looked at other information related to the running of and the quality of the service. This included quality assurance audits, training information for care staff, staff duty rotas, meeting minutes and arrangements for managing complaints.
We asked the registered manager to send us a copy of their training matrix and various policies and procedures after the inspection. They did this within the requested timeframe.
Updated
11 May 2018
We carried out an announced inspection of the service on 16 March 2018. Helping Hands West Bridgford is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It currently provides a service to older adults. Not everyone using Helping Hands West Bridgford receives 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.
There was a registered manager in post at the time of our 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. The current registered manager was due to leave their post soon and a new manager is currently in the process of becoming registered with the CQC. We shall monitor this application.
At the time of the inspection 82 people received some element of support with their personal care. This is the service’s second inspection under its current registration. At the previous inspection, the service was rated as ‘Good’ overall. At this inspection, they maintained that rating. However, the rating for the question, ‘Is the service safe?’ has changed from Good to Requires Improvement. This was because we had concerns with the way people’s medicines were managed.
People told us they were happy with how their medicines were managed. However, we found issues with the way staff recorded when people had or had not taken their medicines and the processes for the administration of ‘as needed’ medicines. People told us they felt safe when staff supported them. The risks to people’s safety were assessed and acted on. More detailed plans for the safe evacuation of people from their homes in an emergency were needed. Staff arrived on time for calls. Robust recruitment processes were in place. Staff understood how to reduce the risk of the spread of infection. Accidents and incidents were investigated and plans were put in place to reduce the risk of them happening again.
People’s care was provided in line with current legislation and best practice guidelines. Staff were well trained and understood how to support people effectively. Staff performance was regularly monitored. The risks to people’s health because of poor nutrition were assessed and acted on.
Information was available to support the involvement of other health and social care agencies where further support was needed for people. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.
People liked the staff who supported them and they found them to be kind and caring. People were treated with dignity and respect. People felt involved with making decisions about their care. People were encouraged to do as much for themselves as possible. People’s diverse needs were respected. People were provided with the information needed to access an independent advocate.
People’s needs were assessed prior to them starting with the service. This enabled the provider to be satisfied that they could meet people’s needs. People felt involved with their care and people were treated equally without discrimination. This included ensuring people with communication needs were offered equal opportunities to access records relating to their care. The majority of people felt care staff responded to their complaints well, although some felt office staff could do more to improve the service they received.
The service was led by a caring registered manager who was well liked by people and staff. Staff enjoyed their jobs, they felt appreciated and excellent performance was rewarded. Relatives had been given the opportunity to comment on the quality of the service provided. People who used the service were soon to have their opportunity to give their formal feedback. The provider ensured the registered manager had the support needed to manage the service effectively. Auditing processes were in place and these had identified some of the issues we identified and were being acted on. The registered manager carried out their role in line with their registration with the CQC.