H+B Homecare Services

H+B Homecare Services provides a palliative domiciliary care service for people living in their own homes in the community. At the time of our inspection, there were nine people using this service. 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

People were satisfied with the care provided and felt safe. Risks had been assessed and risk mitigation plans put in place. The provider followed safe recruitment practices to help ensure suitable people were employed. Staff received appropriate training to meet people’s care needs.

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 procedures for managing incidents, accidents, safeguarding alerts and complaints, and quality monitoring processes were in place, to help monitor and improve service delivery.

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 30 April 2021) and there were breaches of regulation relating to safe care and treatment, consent to care and governance. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an announced comprehensive inspection of this service on 25 February 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, consent to care and governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe, Effective and Well-led which contain those requirements.

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 changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for H+B Homecare Services 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.

H+B Homecare Services provides a palliative domiciliary care service for people living in their own homes in the community. At the time of our inspection, there were 12 people funded either by St Luke's Hospice at Home service or the local Clinical Commissioning Group (CCG).

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

During the inspection we found risk assessments were not always in place and consent to care was not always sought correctly.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. However, the policies and systems in the service did not always support this practice in terms of gaining consent.

The provider had systems in place to monitor, manage and improve service delivery and to improve the care and support provided to people but these were not always effective and did not identify issues raised at the inspection.

The provider had systems in place to safeguard people and staff knew how to respond to possible safeguarding concerns. The provider followed safe recruitment procedures and medicines were managed safely. Staff followed appropriate infection prevention and control practices.

Staff were supported through induction, training and supervision. The provider assessed people's needs to ensure these could be met.

Care plans provided details of people’s preference for care and support and their current needs. There was a complaints procedure in place and the provider knew how to respond to complaints.

People, relatives and staff reported the registered manager was available and responsive.

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 requires improvement (published 19 September 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made/ sustained and the provider was still in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this full report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

H+B Homecare Services provides a palliative domiciliary care service for people living in their own homes in the community. At the time of our inspection, there were 12 people funded by the St Luke's Hospice at Home service or the clinical commissioning group (CCG).

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

Medicines were not always managed safely and we could not be sure people received their medicines as prescribed. Medicines competency testing was not undertaken and medicines audits were only three monthly. The provider did not have any moving and handling risk assessments to mitigate associated risks when moving people.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Supervisions and spot checks were not consistently undertaken.

The provider did not provide information in any different formats to make it more easily accessible to a wider range of people. Care plans did not have information around end of life wishes.

The provider had systems in place to monitor, manage and improve service delivery and to improve the care and support provided to people but these were not always effective and did not identify issues raised at the inspection.

The provider had systems in place to safeguard people from the risk of abuse and staff knew how to respond to possible safeguarding concerns. Safe recruitment procedures were in place. Staff followed appropriate infection control practices to prevent cross infection.

People's needs were regularly assessed to ensure these could be met. People were supported to maintain health and access healthcare services appropriately.

Staff were kind and respectful of people’s wishes and preferences and provided support in a respectful manner. Staff respected dignity and provided day to day choices for people.

There was a complaints procedure in place and the provider responded to complaints appropriately.

People using the service and staff reported the registered manager was approachable and promoted an open work environment.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Responsive and Well Led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report. Since the inspection the provider had begun to take action to mitigate risks identified during the inspection.

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 29 December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

H+B Homecare Services (also referred to as Acacia Community Care Services) offer support to people who require assistance with day to day routines including personal care, cooking and cleaning, live-in care workers and night sittings as well as social care to provide friendship and company on social outings. At the time of our inspection there were 13 people receiving personal care which was funded by the St Luke’s Hospice at Home service for the first 14 days and thereafter transferred to the continuing care department of the Clinical Commissioning Group.

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.

Procedures were in place to safeguard people against the risk of abuse. Staff understood safeguarding procedures and were clear to report any concerns.

Risks were assessed and action plans put in place to minimise them. Staff knew how to respond if someone was unwell including summoning the emergency services.

There were enough staff available to meet the needs of people using the service. Staff recruitment procedures were in place and being followed.

Staff received training and supervision to provide them with the knowledge and skills to care for and support people effectively.

Staff respected people’s rights to make choices for themselves and said they would inform the registered manager if they had any concerns about a person’s capacity to make choices.

People were supported to maintain their nutritional intake and were assisted with meals if required.

Staff knew how to access healthcare input if people required it and understood the importance of ensuring people’s healthcare needs were being met.

Relatives and healthcare professionals expressed their satisfaction with the service and said staff were kind and treated people with dignity and respect. They said staff took the time people needed to ensure their care and support needs were met.

Care records were person-centred and reflected people’s individual needs and wishes. Staff read these so they understood and could provide the care and support people needed.

Procedures for raising complaints were in place and relatives knew how to raise any concerns so they could be addressed.

Feedback from relatives and healthcare professionals showed that the management team were approachable and provided a good service. Care workers said they received good support from the management team and they enjoyed working for the service.

Systems for monitoring the service provision were in place and being followed. The registered manager and staff were responsive and acted promptly to address any issues identified.

At the time of inspection the service did not provide support with medicines.