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We are carrying out a review of quality at UR Hands Care. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Inadequate

Updated 21 November 2019

About the service

UR hands care is a domiciliary care service providing personal care to people living in their own

houses and flats in the community. The service was supporting 13 people at the time of the inspection.

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.

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

People were not safe because the provider had not assessed risks related to their needs and complex health conditions. People were not supported by a staff team who were sufficiently trained, and peoples care plans offered little to no guidance.

The provider had not ensured that recruitment procedures were safe. People were put at risk of harm because Disclosure and Barring Scheme (DBS) checks had not always been completed, employment references had not always been obtained and many staff members had gaps in employment history. This meant that staff members employed may not have suitable character or skills to care for people.

Peoples were not receiving medicines safely. Specialist medicines for people were being given to people without appropriate guidelines and instruction for staff. As and when required medicines had no guidelines in place for staff to follow and many people’s medicine administration records (MAR) had gaps where people may not have received their medicine with no reason recorded.

Staff competency was not being checked. The management team were not checking if staff were supporting people safely. Staff received training, but the management team were not checking if this training was effective. We found some shortfalls in staff skills and knowledge which the

management team were not aware of.

People's abilities were not assessed to enable them to make their own decisions. People's permission to receive care and support was not sought.

People did not have holistic care assessments and reviews in place to check that they were having a positive experience from the service. The management team were not identifying any areas requiring improvement to the care being delivered.

Care records did not contain any information about people’s choices and personal preferences. There was no information about people’s life history, preferences and cultural needs.

People did not have any end of life care plans in place despite providing care for people at the end of their lives.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

The service did not promote a positive person-centred culture which promoted good outcomes for people. Audits and checks at the service were not effective in identifying where improvements could be made. Feedback was not consistently being collected from people and their relatives to inform and possibly improve the service.

Rating at last inspection

The last rating for this service was good (report published on 04 July 2017). At this inspection the service is now rated as inadequate.

Why we inspected

The inspection was prompted in part due to concerns received about staff members being employed without barring and disclosure checks (DBS). The commission also received intelligence suggesting staff members were working for the service with multiple criminal convictions and the provider not having adequate risk assessments in place to monitor staff with such records. A decision was made for us to inspect and examine those risks.

We have found evidence that substantiate some but not all of those concerns. We found concerns in relation to staff employment checks, staff training, management of risks, medicines, leadership and care records. Please see the safe, effective, responsive, caring

Inspection areas

Safe

Inadequate

Updated 21 November 2019

The service was not safe.

Details are in our safe findings below.

Effective

Inadequate

Updated 21 November 2019

The service was not effective.

Details are in our effective findings below.

Caring

Requires improvement

Updated 21 November 2019

The service was not always caring.

Details are in our caring findings below.

Responsive

Inadequate

Updated 21 November 2019

The service was not responsive.

Details are in our responsive findings below.

Well-led

Inadequate

Updated 21 November 2019

The service was not well-led.

Details are in our well-Led findings below.