New Hope Care Ltd

New Hope Care Ltd is a domiciliary and ‘supported living’ service that provides personal care and support to people living in their own homes. The provider is registered to support people with a variety of needs including people who live with dementia, people who misuse drugs and alcohol, people with an eating disorder, people with mental health needs and people with a learning disability, and autistic people. At the time of the inspection the provider was supporting 5 people with learning disabilities/ autistic people.

Some people were supported by staff who lived in people’s homes and provided 24 hour support to people.

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

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.

Right Support:

Risks to people were not always assessed and records required more detail with actions for staff to follow. Improvements were required with the management of medicines to ensure records were accurate and staff had guidance for when to administer ‘as required’ and covert medicines.

People were supported to have choice and control over their own daily lives. The policies and systems in the service supported this practice. However the provider did not fully understand their duties under right support, right care, and right culture in relation to supported living and service models to protect people’s choice and rights in relation to their tenancy and choice of provider.

People were supported by a consistent staff team who knew them well and understood their needs.

Right Care:

Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it. Staff promoted equality and diversity. They understood people's cultural needs and provided culturally appropriate care. Staff protected and respected people's privacy and dignity.

Right Culture:

Improvements were needed to the current systems to make them more effective to monitor the quality of the service and to drive improvements. Audits were not always effective in identifying shortfalls in care practices.

People and those important to them, were involved in planning their care. The care manager and operations manager were open and transparent throughout our inspection and demonstrated a commitment to delivering improvements and achieving best outcomes for people. They were receptive to our feedback and took action to address the shortfalls we found.

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 the service was requires improvement (published 23 February 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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 remained requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well led key question sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for New Hope Care Ltd on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to the management of risk and how the provider monitors the service provided.

Please see the action we have told the provider to take at the end of this 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

Prior to November 2015 the provider was operating under a different company and service name. In November 2015 the provider re-registered with a new service name at this office location. This was our first inspection of the service since it had been re-registered.

The provider is registered to provide support and personal care to adults. People who used the service generally received long term support. However, a local authority had recently given the provider a two month contract to provide short term care packages to people to prevent the need for hospital admission or to enable a timely discharge from hospital. All care and support was provided to people in their own homes within the community. On the day 12 people received a service.

We had been made aware that the local authority had some concerns about the service. These related to missed care and support calls.

A number of missed calls had occurred that had the potential to place people at risk due to them not having the care and support that they had been assessed as requiring. Medicine management recording systems were not always followed by staff to confirm that people had taken their medicines as they had been prescribed by their doctor.

People we spoke with told us that the quality of service was good. Staff felt that they were well supported by the management team. However, we found that there was inadequate monitoring of some aspects of the service. Methods to gain the views of people were in place but these were not always effective to address any issues raised.

A manager was registered with us as is required by law. 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’. The registered manager was also the registered provider. 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 provider had processes in place that staff were aware of and knew that they should follow to prevent people being placed at the risk of abuse. Risk assessments were undertaken and staff knew of the actions they needed to take to keep people safe and minimise any potential risk of accident and injury. Staffing levels ensured that people received a service from staff who they were familiar with, knew of their individual circumstances, and could meet their needs.

Processes were followed to ensure that new staff received induction training and the support they needed when they started work. Training that was required to meet people’s needs and to keep them safe had been delivered to staff. People were enabled to make decisions about their care and they and their families were involved in how their care was planned and delivered. Staff understood that people have the right to refuse care and that care and support must be delivered with their best interests in mind. Staff supported people to prepare drinks and meals when this was required.

People were cared for and supported by staff who were kind and caring. Staff supported people to undertake daily tasks and retain their independence.

The service had responded to people’s needs. Complaints processes were in place for people and their relatives to access if they were dissatisfied with any aspect of the service provision.