3HA Care Services

Updated 28 July 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection team consisted of 4 inspectors and 2 experts by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 72 hours’ notice of the inspection. This was because it is a large service and we needed information in advance of the site visit to contact people about their experiences.

Inspection activity started on 19 June 2023 and ended on 5 July 2023. We visited the location’s office on 22 and 28 June 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from professionals who work with the service. The provider had not submitted a provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We used all this information to plan our inspection

During the inspection

We spoke with the registered manager who was also the provider, manager of a specific area of the service, 2 senior and 13 care staff members. We had emails from a further 6 staff members. We also spoke with 31 people who used the service and 12 of their relatives. We had email communication from 5 professionals.

We reviewed 19 people's care records and 6 staff files in relation to recruitment. We reviewed training records and documents relating to the management of the service.

Updated 28 July 2023

About the service

3HA is a domiciliary care service providing personal care. The service provided support to 8 people with a learning disability and autistic people and 177 to older people and people with a physical disability.

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

The provider did not have robust processes in place to monitor the service in relation to audits, risk assessments or medicines management to ensure safe oversight and governance of the service. Staff did not always have all the information they needed relating to risks to people.

Staff were not always safely recruited in line with government guidance.

There were enough staff to provide people with their care and support.

Infection control procedures were in place and staff had access to personal protective equipment (PPE) as required.

Staff knew how to safeguard people from harm and people told us they felt safe using the service. People were supported by staff who received an induction and training to meet their needs. Staff ensured people had support with meals and drinks and accessing health and community services.

People and their relatives told us the staff were kind and caring and respected their dignity and privacy.

People were given information on how to complain and feedback was sought through reviews and surveys. No one at the service was receiving end of life care.

Staff described a positive culture within the service and felt well supported by the registered manager and management team.

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.

The service was able to demonstrate how they were meeting the underpinning principles of 'Right support, right care, right culture.'

Right Support

Staff provided people with the support they needed to live their life as they chose. People’s choices, wishes and aspirations were respected by staff, and they supported people to be as independent as possible.

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.

Right Care

People received kind and compassionate care. Staff treated people with respect and dignity. They knew people well and responded to their individual needs.

Right culture

People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received support that was tailored to their needs.

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

Rating at the last inspection. The last rating for this service was good (published 10 August 2017).

Why we inspected

The inspection was prompted in part due to concerns received about people’s care and support. A decision was made for us to inspect and examine those risks.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We have identified breaches in relation to the recording of information about risk assessments and quality assurance and governance arrangements at the service.

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.