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Care Hand Service Ltd

Overall: Good read more about inspection ratings

37 Woodlands, Harrow, Middlesex, HA2 6EJ

Provided and run by:
Care Hand Service Ltd

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about Care Hand Service Ltd on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about Care Hand Service Ltd, you can give feedback on this service.

12 June 2018

During a routine inspection

We undertook an announced inspection of Care Hand Service Ltd on 12 June 2018.

Care Hand Service Ltd is a small domiciliary care agency registered to provide personal care to people in their own homes. The service focuses on providing care to people who are registered deaf, those with multi-sensory needs and other disabilities. At the time of the inspection, the service provided personal care to three people. CQC only inspect the service 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.

During our previous inspection in June 2017, we noted that there was no registered manager in post. The service had taken action in respect of this and this inspection in June 2018 found that there was 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.

The previous inspection on 12 June 2017 found three breaches of regulation and made one recommendation. We rated the service as "requires improvement". During this inspection on 12 June 2018, we found that the service had made improvements in respect of care documentation, risk assessments, staff training, supervision, quality checks and audits. We also noted that the service had made some improvements in respect of their medicines management. However, there were still areas within the medicines management that required improvement. We also observed that the service had introduced various checks and audits. However, we noted that medicines audits were not effective.

People who used the service were registered deaf and therefore were unable to verbally communicate with us. We therefore spoke with their representatives. They informed us that overall, they were satisfied with the care and services provided. They said that people were treated with respect and people were safe when cared for by care workers.

Our previous inspection found a breach of regulation in respect of risk assessments. We found that the service did not always identify all potential risks and there was limited information contained in risk assessments. During this inspection in June 2018, we found that the service had taken appropriate action and made improvements to their risk assessments. Appropriate risk assessments were in place and included details of the nature of the risk, action required to minimise the risk and details of progress of actions taken by the service.

Our previous inspection found a breach in respect of medicines management. We found that the service was not completing Medication Administration Records (MARs) when administering medicines to people. People were therefore at risk of not receiving their medicines safely. During this inspection, we noted that the service had taken action in respect of this and made improvements. The service had introduced systems to ensure that medicines were administered safely. However, we found that there were still some issues with regards to the completion of MARs and raised this with the service. Following the inspection, the nominated individual confirmed that they had reviewed their MARs and had implemented a revised format that enabled them to document medication administration consistently.

Representatives told us there were no issues with regards to care worker's punctuality and attendance. They told us that care workers were usually on time and if they were running late, the office contacted them to inform them of the delay. They told us that people experienced consistency in the care they received and had regular care workers.

At the time of the previous inspection in June 2017, the service did not have an electronic system for monitoring care worker's timekeeping and duration of their visit. During this inspection in June 2018, the service had a telelogging system in place which flagged up if a care worker had not logged a call to indicate they had arrived at the person's home or that they were running late.

We looked at the recruitment records and found background checks for safer recruitment had been carried out to ensure staff were suitable to care for people.

Care plans included information about peoples’ mental health and their levels of capacity to make decisions and provide consent to their care.

Representatives told us that people were treated with respect and dignity. They told us that care staff were caring and helpful. Staff were able to give us examples of how they ensured that they were respectful of people’s privacy and maintained their dignity. Staff told us they gave people privacy whilst they undertook aspects of personal care.

Our previous inspection found that there was a lack of consistency and the quality of care documentation varied. During this inspection in June 2018, we noted that the service had made improvements and ensured that care records were consistent.

We previously found that communication records were poorly written and not professional and we made a recommendation in respect of this. During this inspection, we noted that the service had taken action to address this. We looked at a sample of communication records and found that these were consistent and were written in a professional manner.

Care support plans were individualised and addressed areas such as people’s personal care, what tasks needed to be done each day, time of visits, people’s needs and how these needs were to be met. They also included details of people’s preferences.

The service had a formal complaints procedure in place. We noted that the service had not received any formal complaints since the previous inspection.

Representatives and care workers we spoke with were satisfied with the management at the service. They said that management were approachable and supportive. Our previous inspection found that the service did not have a system in place to monitor the quality of the service and we found a breach of regulation in respect of this.

During this inspection in June 2018, we found that the service had made improvements to address the breach of regulation. We noted that the service had introduced care plan and risk assessment audits. The service also carried out regular staff spot checks and supervisions to monitor care workers. We also noted that the service had introduced an electronic telelogging system to monitor staff punctuality and attendance. However, during this inspection we noted the service did not have an effective medicine administration audit in place. The service had failed to identify the gaps and inconsistencies in a sample of MARs we looked at. We raised this with the service. Following, the inspection the service sent us evidence of the new format of medicines audit they had devised and said it would be implemented immediately.

12 June 2017

During a routine inspection

We undertook an announced inspection of Care Hand Service Ltd on 12 June 2017.

Care Hand Service Ltd is a small domiciliary care agency registered to provide personal care to people in their own homes. The service focuses on providing care to people who are registered deaf, those with multi-sensory needs and other disabilities. At the time of the inspection, the service provided personal care to three people.

At the time of the inspection there was no registered manager in post. The nominated individual explained that the previous manager who was in the process of registering with the CQC recently left the organisation. There was a new manager in post at the time of the inspection and she confirmed that she had started working for the service in May 2017. We were provided with evidence to confirm that the new manager had applied to register with the Care Quality Commission (CQC). 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 and associated Regulations about how the service is run.

The service registered with the CQC in December 2015. This inspection on 12 June 2017 was the first inspection for the service.

People who used the service were registered deaf and therefore were unable to verbally communicate with us. We therefore spoke with their relatives. Relatives informed us that they were satisfied with the care and services provided. They said that people were treated with respect and people were safe when cared for by the service.

Individual risk assessments were completed for each person. However, the assessments contained limited information and some areas of potential risks to people had not been identified and included in the risk assessments. This could result in people receiving unsafe care and we found a breach of regulations in respect of this.

There were processes in place to help ensure people were protected from the risk of abuse.

During the inspection, we found the service was not completing Medication Administration Records (MARs) when administering medicines to people. People were therefore at risk of not receiving their medicines safely and we found a breach of regulation in respect of this.

People using the service experienced consistency in the care they received and had regular care staff. Relatives we spoke with confirmed this and said that they were happy about this.

Care workers told us that they felt supported by management. They told us that management were approachable and they raised no concerns in respect of this. However, during this inspection we found that there was a lack of evidence to confirm that staff had received supervision sessions and further there was no evidence to confirm that three out of six members of staff had received further training other than the induction they received when they started working at the service. It was therefore not evident that all staff had been consistently supported to fulfil their roles and responsibilities and we found a breach of regulation in respect of this.

Care plans included information about peoples’ mental health and their levels of capacity to make decisions and provide consent to their care.

Relatives told us that people were treated with respect and dignity. They told us that care staff were caring and helpful. Staff were able to give us examples of how they ensured that they were respectful of people’s privacy and maintained their dignity. Staff told us they gave people privacy whilst they undertook aspects of personal care.

Care plans were individualised and addressed areas such as people’s personal care, what tasks needed to be done each day, time of visits, people’s needs and how these needs were to be met. They also included details of people’s preferences. However, we noted that there was a lack of consistency in the care records we looked at. We found that the quality of care documentation varied in each of the care plans we looked at and made a recommendation in respect of this.

The service had a formal complaints procedure in place. We noted that the service had not received any formal complaints since the service registered with the CQC.

Relatives and staff we spoke with were satisfied with the management at the service. They said that management were approachable and supportive. However, we found that the service did not have a system in place to monitor the quality of the service being provided to people using the service and to manage risk effectively. The service had failed to effectively check essential aspects of the care provided and did not have a quality and audit overview of the service. We found a breach of regulations in respect of this.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.