Archived: Human Support Group Limited - West Leeds

Human Support Group is a domiciliary care service providing personal care to people 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 the time of inspection, 131 people were receiving personal care.

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

We saw an improvement to medicines since the last inspection. These were managed and administered safely. Where risks were identified these were assessed and mitigated by the provider.

People told us they felt safe with the staff who supported them. However, people told us they were not always supported by a consistent staff team.

We received mixed views from people and staff about the registered manager and the service. People told us they did not always fell listened to.

Peoples needs were assessed prior to them receiving a service. We found some reviews were out of date. However, the registered manager had an action plan in place and was working through these at the time of inspection. 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.

Recruitment checks and records were robust.

People were supported by kind and caring staff who treated them with respect. People’s independence was encouraged.

People and their relatives were supported to be involved with the development of the care plans.

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 this service was requires improvement (published 16 August 2018). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

The last rating for this service was requires improvement (published 16 August 2018). We will describe what we will do about the repeat requires improvement in the follow up section below.

Why we inspected

This was a planned inspection based on our inspection schedule.

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 service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults. Not everyone using Human Support Group West Leeds receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

Human Support Group West Leeds is registered with the Care Quality Commission to provide personal care to people in their own homes.

At the time of our inspection, 142 people were supported with their personal care needs by the service. There was a registered manager in post. 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.

At our last inspection of the service on 13, 15 and 23 June 2017 we found staff were not always supported in their roles and there were not effective systems in place to monitor support and supervision with staff members. At this inspection we found the provider had undertaken improvements to the quality of care people received. However, we found concerns in other areas.

There was a registered manager in post. 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.

Staff had not always supported people safely with their medicines if required. Records of medicines administration had not always been documented and medicines care records did not always direct staff on how people liked to take their medicines.

Mostly people told us they felt safe. Staff understood how to recognise and report signs of abuse or mistreatment. Staff had received training on how to recognise the various forms of abuse, which was regularly updated and refreshed. The provider carried out risk assessments to identify any risks to people using the service and to the staff supporting them. There was a lone working policy, which staff knew about. Safe recruitment processes were completed.

The provider had recognised the need to recruit sufficient numbers of staff to keep people safe. The staff team had recently had lots of changes both with caring staff, office staff and management. This had affected some people with their continuity of care. The rota recorded details of people's visit times and which staff would provide the visit. The registered manager or senior staff were on call outside of office hours and had access to the rota, telephone numbers of people using the service and staff with them.

Staff followed good infection control practice. Staff knew the reporting process for any accidents or incidents. Records showed that the provider had taken appropriate action where necessary, and made changes to reduce the risk of a re-occurrence of an incident. The service had suitable processes to assess people's needs and choices, the care lead went out to assess people prior to a package of care commencing to check the service could meet the person's needs.

Staff had appropriate skills, knowledge, and experience to deliver effective care and support. All new staff completed the Care Certificate. The Care Certificate is an identified set of national standards that health and social care workers should follow when they are new to working in the care sector. Staff completed food hygiene training, they knew about good practice when it came to nutrition and hydration.

Staff asked people for their consent before delivering care or support and they respected people's choice to refuse care. Care records showed that people signed a contract of care where they gave their consent to the care and support provided. All the people we spoke with said they had been included from the beginning in planning their care.

The provider was responsive to people's needs. Staff supported people, and involved them, (as far as they were able), to draw up and agree their own support plan. All the relatives we spoke with said they had good communication with most staff at every level and were involved in their relative's care. People are supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The provider sought people's feedback and acted to address issues raised. There was a system in place to manage and investigate any complaints. People had information about how to make a complaint in their care records and in their home. The provider recorded incidents and accidents for patterns of behaviour. They used this information to consider any changes in a person's support needs and how staff could meet those needs.

There was a management structure in the service, which provided clear lines of responsibility and accountability. Staff were valued by the provider and their contributions were appreciated and celebrated.

There were quality assurance arrangements at the service to raise standards and drive improvements. The service's approach to quality assurance included completion of an annual survey. The provider had ensured they complied with all relevant legal requirements, including registration and safety obligations, and the submission of notifications.

Further information is in the detailed findings below

There was a registered manager in post. 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.

Staff had not always received supervision in line with the provider’s policy. The registered manager was aware of the issue and had taken action to change the process to ensure staff would be supervised.

People received care from staff who were kind and caring and who treated people with dignity and respect. The staff were well trained and the provider had systems in place to protect people from the risk of abuse. There were enough staff to meet people's needs.

People received their medicines when they needed them and staff asked them for their consent before providing them with care. The staff acted within the requirements of the Mental Capacity Act 2005 when providing care to people who were unable to consent to it themselves.

People's care needs had been assessed and were being met. However, staff did not always provide care at people's preferred times. Information was in place to guide staff on what care people needed to provide to meet some someone’s specific needs.

The provider had systems in place to monitor the quality of service being provided. Audits had been conducted and had identified improvements that were required to the service and these were being addressed. The service actively sought people’s feedback on the service through phone calls, spot checks and surveys.

Staff were happy working for the provider and felt supported in their role. The provider had promoted an open culture where both staff and people using the service could raise concerns without any hesitation. People knew how to complain and any complaints were investigated and responded to.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full report.