Archived: Hyde Park Care

Hyde Park Care is a domiciliary care agency registered to provide personal care to people in their own homes. At the time of our inspection, the service told us that they were providing care to 47 people. One person who received care from Hyde Park Care did not receive a regulated activity. 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.

At the time of the inspection there was no registered manager in post. The previous registered manager left the organisation in March 2018. A new manager was appointed in March 2018 and we met the new manager during the inspection. The director of the service and the new manager confirmed that she would apply 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 previous inspection on 4 April 2017 found three breaches of regulation and made one recommendation. We rated the service as "requires improvement". During this inspection 23 April 2018, we found that the service had made improvements in respect of care documentation, complaints recording, 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 consistent.

People who used the service and relatives told us that they were satisfied with the care provided and raised no concerns. People told us they were treated with respect and felt safe when cared for by the service. People and relatives spoke positively about care workers and management at the service.

Risk assessments were in place which detailed potential risks to people and how to protect people from harm. Systems and processes were in place to help protect people from the risk of harm. Care workers had received training in safeguarding adults and knew how to recognise and report any concerns or allegations of abuse.

Our previous inspection found numerous deficiencies in respect of medicines management and we found a breach of regulation in respect of this. During the inspection, we noted that the service had taken action in respect of this and made improvements. The service had introduced numerous systems to ensure that medicines were administered safely. However, we found that there were still some issues with regards to the completion of Medication Administration Records (MARs) and raised this with the manager. Following the inspection, the manager confirmed that they would change the system used for recording administration of medicines.

People we spoke with told us that 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 called to inform them of the delay.

At the time of the previous inspection in April 2017, the service did not have an electronic system for monitoring care worker’s timekeeping and duration of their visit. During this inspection in April 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 workers we spoke with told us that they felt supported by the manager. They told us that management were approachable and they raised no concerns in respect of this. Our previous inspection found that care workers lacked knowledge of certain areas of care. Further, staff were not consistently supported to fulfil their roles and responsibilities through training, regular supervisions and appraisals. During this inspection we found that care workers had completed training and received regular supervisions and appraisals where necessary.

Care support plans were person centred and focused on the individual needs of people. Support plans included a section titled “Information about me” and “What you need to know and do to respect my lifestyle choices”. This included information about family and important relationships, how the person likes to live their life, places and events that are important to them, religious and cultural preferences and activities they like to do.

Care workers were aware of the importance of respecting people’s privacy and maintaining their dignity. They told us they gave people privacy whilst they undertook aspects of personal care. People who used the service told us that they felt confident in care provided by the service.

The service encouraged people to raise concerns. Our previous inspection found that the service did not consistently document what subsequent action was taken by the service following a complaint and we made a recommendation in respect of this. During this inspection, we noted that the service had taken appropriate action and we saw that complaints were fully documented and there was a clear record of what action the service had taken in response to the complaint.

There was a management structure in place with a team of care workers, field care supervisors, care coordinators, office staff, the manager and director. Staff spoke positively about the management and culture of the service and told us the management were approachable if they needed to raise any concerns.

We previously found that the service did not have effective systems and processes in place to assess, monitor and improve the quality of the services provided and we found a breach of regulation in respect of this. The previous inspection found that the service failed to carry out regular and consistent checks and audits in relation to staff spot checks, staff supervisions, care plans, complaints, medicines administration, staff attendance and punctuality. During this inspection we noted that the service had made improvements to address the breach of regulation. We noted that the service had introduced care plan audits and we saw evidence of this in people’s care records. The service also carried out regular and consistent staff spot checks and regular supervisions to monitor care workers. We also noted that the service had introduced an electronic telelogging system to monitor staff punctuality and attendance and this system was running effectively. The service also had a comprehensive system for monitoring complaints and ensuring that they were dealt with appropriately.

Our previous inspection found that there was not a documented and formal medicines administration audit in place. During this inspection in April 2018, we noted that the service had introduced a system for auditing medicines administration. However, we found that the system was not implemented consistently and had failed to consistently identify issues with regards to MARs. We discussed this with the manager and director and they confirmed that they would review their system to ensure that it was operating effectively.

The service had a system in place to obtain feedback from people and relatives about the quality of the service they received through telephone monitoring, home visits and review meetings. We also saw evidence that field care supervisors and care coordinators carried out regular and consistent spot checks to assess care worker's performance.

Staff we spoke with said that management and staff worked well together as a team and said that the morale within the service was positive. They said that management was approachable and that there was an open and transparent culture. Staff told us they would not hesitate to bring any concerns to management.

Hyde Park Care is a domiciliary care agency registered to provide personal care to people in their own homes. At the time of our inspection, the service told us that they were providing care to 55 people.

At the time of the inspection there was no registered manager in post. The previous registered manager left the organisation in January 2017. There was a new manager in post at the time of the inspection. 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.

Hyde Park Care was previously registered with the CQC at a different address. Hyde Park Care re-registered with the CQC at the new location in December 2015. This was the first inspection of the service.

People who used the service and relatives informed us that they were satisfied with the care and services provided. People told us they were treated with respect and felt safe when cared for by the service. They spoke positively about care workers and management at the service.

Risk assessments had been carried out and detailed potential risks to people and details of how to protect people from harm.

There were processes in place to help ensure people were protected from the risk of abuse. However, despite receiving safeguarding training, some care workers we spoke with were unable to describe the process for identifying and reporting concerns and were unable to give example of types of abuse that may occur.

There were some arrangements to manage medicines safely and appropriately. Records showed care workers had received medicines training and medicines policies and procedures were in place. However, we found unexplained gaps in people’s Medication Administration Records (MAR) and found that MARs were not always completed fully. People were therefore at risk of not receiving their medicines safely and we found a breach of regulation in respect of this.

All people we spoke with told us that generally care workers were on time and they raised no concerns regarding this. We also asked people if there were any instances where care workers had failed to arrive for a scheduled visit. People told us that care workers arrived for their contracted visits and stayed for the duration of the time required.

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 workers we spoke with told us that they felt supported by the manager. They told us that management were approachable and they raised no concerns in respect of this. However, we found that care workers lacked knowledge of certain areas of care. Some of the training provided to care workers was not effective as there were deficiencies in their knowledge. Care workers had received supervision sessions in March 2017 but we noted that prior to this they had not consistently received supervision sessions. Staff had not received an appraisal in the last year. We found that there was a breach of regulations in respect of this.

New format care support plans included information about people’s mental health and their levels of mental capacity to make decisions and provide consent to their care.

Care workers were aware of the importance of respecting people’s privacy and maintaining their dignity. They told us they gave people privacy whilst they undertook aspects of personal care. People who used the service told us that they felt confident in care provided by the service.

The service had a complaints procedure and complaints received were recorded. Complaints had been responded to, however subsequent action taken in respect of a complaint received was not always clearly documented. We have made a recommendation in respect of this.

New format care support plans were person centred and included information about people’s preferences. These included information about the support that people required from care workers. However, we noted that there were some care support plans that were in the old format and these lacked information about people’s preferences. We spoke with the nominated individual about this and he explained that they were currently updating all care plans and ensuring that they were in the new format.

There was a management structure in place with a team of care workers, field care supervisors, office staff, the manager and the nominated individual. The provider had notified us of the changes in management at the service in January 2017. The registered manager left the service and consequently the nominated individual was responsible for the running of the service until a new manager was in post. A new manager was appointed in March 2017 and has applied to register with the CQC as the registered manager of the service. Between January 2017 and our inspection on 4 April 2017, we received information raising concerns about aspects of the care provided by the agency. During the inspection, we discussed these concerns with the nominated individual and manager and they explained that the service had been working hard to make improvements to the service. We spoke with the Local Authority who had regular contact with the service. This care professional told us that the service was committed to making improvements and they had responded well in difficult circumstances.

We found that the service did not have an effective 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 in respect of late visit monitoring and MARs. We found a breach of regulations in respect of this.

During the inspection, management explained to us that they had made improvements to aspects of the care and showed us evidence of this. However, we noted that there were still some areas that the service were in the process of addressing but had not yet completed. We also observed that the new manager had implemented new processes since she had started working at the agency. However, we did not see evidence that these processes had been implemented consistently over a significant period of time.

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