We carried out a review of the data available to us about Four Hills Care Limited 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 Four Hills Care Limited, you can give feedback on this service.
Four Hills Care Limited is a domiciliary care agency providing personal care for people living in and around Westbury. 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. At the time of inspection 43 people were receiving a service.
People’s experience of using this service and what we found
People were supported by staff they knew well. There was a continuity of care provided by staff who people told us were caring. The registered manager told us they would only take on additional packages of care if they had staff to support people safely. Staff were trained and supported by management. Risks were assessed and recorded, and staff had access to all management plans they required.
People told us they felt safe and staff had been trained in safeguarding. Staff understood how to report any concerns and management had worked with the local authority safeguarding team when needed. People had their medicines as prescribed and there was guidance for staff to know what support people needed. We have made one recommendation about ‘as required’ PRN medicines needing more details.
People knew how to complain and told us they would if they needed to. People had care plans which gave guidance on how they wanted to be cared for. These were reviewed regularly. Care plans were electronic, so staff could access them at any time. People and relatives could also access their records when they wished.
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. People’s consent to their care package was recorded in their care plans.
Staff had been recruited safely. Staff told us they enjoyed their work and felt supported in their roles by the management team. There was good teamwork and staff told us they all supported each other when needed. Team meetings were held regularly so staff could share information.
Quality monitoring systems were in place and were effective at identifying improvements. The service worked in partnership with many healthcare professionals. There was guidance for staff to know about people’s health needs in their care plans. We have made a recommendation about information provided to staff on knowing how to support people’s diabetes.
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 24 April 2017).
Why we inspected - This was a planned inspection based on the previous rating.
Follow up - We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
This inspection took place on 4 April 2017 and was announced. The provider was given short notice because the location provides domiciliary care services. We wanted to make sure the registered manager would be available to support our inspection, or someone who could act on their behalf. This also gave us the opportunity to ensure people and staff would be available to talk with us. The inspection was carried out by one inspector. This service had not been previously inspected.
A registered manager was employed by the service who was present throughout the inspection. The registered manager is also the provider. 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 provider used up to date technology to help them provide a service that was responsive to people’s changing needs. This gave staff access to electronic information they needed to meet people’s needs, including receiving regular up to date information.
People received care and support from staff who had gotten to know them well. Staff knew how to protect people’s privacy and told us how they would support people with intimate care in a way which maintained their dignity. Staff told us people’s care was not rushed enabling them to spend quality time with them.
Staff knew the different types of abuse and what constituted poor practice. They knew how to report any concerns raised and had confidence they would be listened to and appropriate actions would be taken by the registered manager. Measures were in place to manage the risk of harm to people.
People received care and support from staff who were regularly supervised and their performance and ability to do the job was checked. People were supported by staff who knew them well and understood their needs. Staff received training appropriate to their role and were able to access additional training where required.
People who required support with their medicines were supported by staff to receive them safely. Staff had received training in the safe handling and administering of medicines and had their competency assessed by a senior member of the team. People’s health and wellbeing were monitored and recorded in daily records. Any concerns were raised with the registered manager, appropriate health professional and where appropriate the person’s relative.
The service was working within the principles of the Mental Capacity Act 2005. Staff had an understanding of the Mental Capacity Act 2005 and explained how they supported people to make decisions regarding their daily living. People told us staff sought permission before undertaking any care or support.
The registered manager sought feedback from people to ensure the quality of care was maintained. People, their relatives and staff were supported and encouraged to share their views. The registered manager investigated complaints and concerns. Quality assurance systems were in place to monitor the quality of care and service being delivered.
The registered manager was passionate about wanting to provide people using the service with high quality care and support, which included end of life care. These values were strongly shared by the staff we spoke with. There was a very positive and open culture within the service.