Background to this inspection
Updated
2 February 2021
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 Care Act 2014.
Inspection team
The inspection was carried out by a single inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was announced. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection. We also needed to ensure consent was obtained for us to contact people and their relatives by telephone, to obtain their views about the care provided. Inspection activity started on 3 December and ended on 14 December 2020. We visited the office location on 7 December 2020.
What we did before the inspection
We looked at information we held about the service to help us plan the inspection. This included any notifications the provider had sent to tell us about important events when they happened at the service. We also spoke with local health care commissioners involved in people’s care at the service. On this occasion we did not ask the provider to complete a Provider Information Return (PIR) before the inspection. This is information we may ask the provider to send us, usually at least once annually, to give some key information about the service, what they do well any improvements planned. However, we gave the registered manager opportunity during the inspection to give us any relevant updates from this.
During the inspection
We used a range of methods to help us understand people’s care experience. We spoke with two people, two relatives and one person’s chosen representative. We also spoke with the registered manager and four care staff, including a senior. We looked at three people’s care plans to check whether they were accurately maintained and a range of other records relating to the management of the service. This included staffing, medicines, complaints, incident and safeguarding records. The provider sent us a range of information that we asked them to. This included the service guide and statement of purpose. It also included some of the provider's care policies, care survey results. and management audits.
After the inspection
We spoke with two external professionals involved in people’s care.
Updated
2 February 2021
HQ is a care at home service providing personal care to people living in their own homes. 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 this inspection there were seven people receiving personal care. Most of whom were living with a life limiting illness, whose personal care was an agreed element of a palliative or end of life care package via local health care commissioners.
People’s experience of using this service and what we found.
The service was not consistently well managed. Operational care and management structure arrangements did not always fully ensure effectively informed or timely care. Related service improvements needed were not always either identified or assured in a timely manner. The provider had not always notified us of important events when they happened at the service, in timely manner.
The provider’s staffing, risk management, medicines and safeguarding arrangements, helped to ensure people’s safety when they received care. Recognised hygiene measures were followed for the prevention and control of infection. Health incidents and near misses were routinely monitored and analysed, to help inform or improve peoples’ care and prevent any further reoccurrence when needed.
There were effective arrangements for the assessment, planned delivery and review of people’s care. People were supported to maintain or improve their health and nutrition in consultation with relevant external health professionals, when needed for people’s care.
Staff were trained and supported for their role. People were supported to have maximum control of their care and staff supported them in the least restrictive way possible. The provider’s related policies and systems supported this practice.
People were supported by caring staff, who knew people well and how to communicate with them. Nationally recognised care values associated with adult social care, were established within the service and followed by staff, to ensure people’s dignity, equality, choice and rights in care.
The provider was meeting the accessible information standard, to enable people to understand and agree their care, in accordance with their assessed needs. Complaints and regular feedback sought from people and others with an interest in their care were effectively informed, handled and used to influence any care or service improvements needed.
People were overall happy with their care and to recommend the service to friends and family. Personal care arrangements to support people’s end of life care needs were effectively considered against nationally recognised care standards. This helped to ensure people’s dignity, comfort and choice in any event.
Effective arrangements were established for communication, record keeping and information handling at the service; along with considered engagement and partnership working for people’s care and safety.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
This service was registered with us on 15/02/2016 and this is the first inspection.
Why we inspected
This was the first comprehensive ratings inspection of the service. The inspection was prompted in part due to concerns received about the service regarding management and staffing arrangements. A decision was made for us to inspect and examine those risks.
We looked at infection prevention and control measures under the Safe key question. We look at this in our inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.