Human Support Group Limited - Whitehaven

Human Support Group Limited- Whitehaven is a domiciliary care service providing personal care to people with a range of care needs, including older people, younger adults, people living dementia and people living with physical disabilities. At the time of our inspection there were 65 people using the service.

Not everyone who used the service received personal care. The Care Quality Commission (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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location supported one person with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

People felt safe and confident with the staff supporting them. Staff responded appropriately when incidents occurred or people experienced changes in their health needs. Information about people’s health conditions and risks associated with these was not always recorded in detail to ensure staff would know how to respond if issues arose. We have made a recommendation about risk assessment and management plans.

People were supported by staff who had been recruited safely and had received training to support them. We have made a recommendation about learning disability and autism training to support staff knowledge and skills.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The provider had quality assurance systems established to monitor the quality of care provided at the service and any areas for improvement. The registered manager and provider were committed to making improvements. People were encouraged to give feedback on the service, which was used to drive change.

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

Rating at last inspection

The last rating for this service was good (published 30 March 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the key questions of Safe and Well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has stayed as good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Human Support Group Limited- Whitehaven on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

When we last visited the service in November and December 2016 we judged the service to be in breach of Regulation 12, Safe care and treatment, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because risks associated with the delivery of safe care and treatment, including the safe use of some equipment, had not always been recognised and when risks had been identified they were not always recorded appropriately. At this inspection we judged that risk assessments and risk management plans were in place for all service users, the staff and for the work undertaken.

Following the last inspection we asked the provider to complete an action plan to show what they would do and by when to improve the key questions safe, responsive and well led to at least good. We received a suitable action plan and updates on progress. At this inspection we judged that the service was no longer in breach of Regulation 12 and that these outcomes were now rated as good. This was because risk, assessment and care planning had improved and that the registered manager had developed and implemented suitable systems to support the team.

We noted that the registered manager had used the outcomes of the last inspection to develop an improvement plan. We saw that lessons had been leaned from the last inspection and that suitable action had been taken to move the service forward.

Human Support Group provides care and support for people who live in their own homes. The office is located in a business park outside Whitehaven and provides services in the Copeland and Allerdale areas. There were approximately 100 people using the service when we inspected.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults. Not everyone using Human Support Group Limited - Whitehaven receives a 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.

The service had a suitably qualified and experienced registered manager who also managed the provider's services in Ulverston and Carlisle. 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 service had good arrangements in place to ensure people who used the service were kept as safe as possible. Staff were trained to help prevent people from being subject to harm and abuse.

We saw that staff received good levels of training and supervision to help them to understand the issues around discrimination and human rights.

We had evidence to show that there were detailed and up to date risk assessments and risk management plans in place for all aspects of the service. The organisation had an emergency plan.

There were suitable arrangements in place for staff to voice their concerns because the service had a 'whistleblowing' procedure and staff felt confident that they could approach management with any concerns.

Arrangements were in place to monitor any incident or accidents and the service had improved the systems to notify the Care Quality Commission, safeguarding teams and social work staff.

Staffing levels were suitable to meet the needs of people using the service. New staff were appropriately recruited, given suitable induction, closely monitored and supervised for the first few months. Staff received good levels of training in a wide range of subjects. Appropriate disciplinary and grievance systems were in place.

Good arrangements were in place to help staff support people with their medicines. The staff alerted social workers, health care providers or family carers if there were issues with medicines.

Staff received training and supervision in relation to infection control and good hygiene standards so that they helped people to have clean and safe homes.

The registered manager had a very good understanding of the Mental Capacity Act 2005 and had judged that no one was receiving a service against their wishes. There was good evidence that the organisation sought consent from service users where possible. Restraint was not used in the service.

Staff helped some people to budget, shop and prepare food. Staff were given support to ensure people received suitable nutrition and hydration.

People were given the right levels of support to consult their GP, community nurses and specialised health care professionals, where necessary.

People told us that the staff were respectful and caring. Independence was promoted. People could be given information about advocacy services.

People who used the service had detailed and up to date care plans and good risk management plans.

Staff supported people to gain access to community activities and were developing extra services to help people become less socially isolated.

The organisation had a suitable management structure. The registered manager had responsibility for the service but delegated some aspects to senior carers, senior care co-ordinators and care co-coordinators. This arrangement now worked more effectively than before. The provider was considering some changes to the management structure.

The core values of the organisation were seen in care planning and recording and were identified by people who used the service.

Good audits of quality were in place and these were part of a robust system of total quality management.

Record keeping was detailed and up to date. The service was transitioning over to a 'paperless office' system and some aspects of this were being progressed to ensure the keeping of records was suitable. Records were secure yet accessible.

The service used new technology. We recommended that the systems used to support good communication were monitored so that these could continue to improve.

Human Support Group provides care and support for people who live in their own homes. The majority of people using the service are older people. The office is located in Whitehaven and provides services in and around the local areas. There were 129 people using the service when we inspected.

The service has 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. The registered manager of the service had responsibility for two other Human Support Group services in Cumbria, one in Carlisle another in Ulverston, as well as this one in Whitehaven.

This service had been previously owned by different providers and we noted that the whole staff team had undergone some changes that had at times impacted on the delivery of the service. At the time of this inspection we could see that significant changes had been made to establish a more settled and sustainable staff team.

During this inspection we found a breach of Regulation12 Safe care and treatment of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 this was because some risks associated with people’s care had not been managed effectively.

We found risks associated with the delivery of safe care and treatment including moving and handling and the safe use of some equipment had not always been recognised. Even when these risks had been identified they were not always recorded accurately.

There was enough staff to provide the care people required. We saw that staffing levels were good with a number of flexible and part time staff employed. The staff had completed training to ensure they had the skills to provide the care and support individuals needed. The staff team were supported by the senior staff and members of the management team through regular staff supervision, appraisals and team meetings.

Staff knew how to identify and report concerns about a person’s safety. The recruitment process for new staff included all the required checks to ensure that they were suitable to work in people’s homes. This helped to protect people from the risk of abuse. Recruitment procedures were generally thorough and this ensured only suitable people worked in the service.

The quality of care plans and risk assessments recorded were not consistent and information about some people’s care needs was not always recorded. New care planning documentation was being introduced across the whole service in December 2016.

Most people received support from a regular team of staff who they knew and who understood the care and support people required. People told us they were treated with kindness and respect and made positive comments about the staff who visited their homes.

People’s dietary needs and preferences had been identified and staff could tell us about people’s individual dietary requirements.

We found that the service worked very well with a variety of external agencies such as social services, other care providers, local GP’s and community nurses to provide appropriate care to meet people’s physical and emotional needs.

People had been included in agreeing to the support they received and were asked for their views about the service. The registered manager was knowledgeable about the Mental Capacity Act 2005 and about their responsibility to protect the rights of people who could not make important decisions about their own lives.

The current auditing systems that look at the quality of care records and risk assessments had not identified some of the concerns we found during the inspection. This meant that some audit checks were not always robust.

We have made a recommendation that the systems in place are reviewed to improve the quality of the auditing process.

‘You can see what action we told the provider to take at the back of the full version of the report.’