Helping Hands Harrow

Updated 26 October 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014.

The inspection on 25 September 2018 was carried out by one inspector. We gave the provider notice of our inspection as we needed to make sure that someone was at the office in order for us to carry out the inspection. We also wanted to speak with care staff on the day of the inspection and providing advanced notice gave the service time to arrange for care staff to visit on the day of the inspection.

At the time of the inspection, the service provided personal care to five people.

Before we visited the service we checked the information that we held about the service and the service provider including notifications we had received from the provider about events and incidents affecting the safety and well-being of people. The provider also completed a Provider Information Return (PIR). The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The PIR also provides data about the organisation and service.

During our inspection we went to the provider’s office. We reviewed four people’s care plans, five staff files, training records and records relating to the management of the service such as audits, policies and procedures. The majority of people who received care were unable to communicate with us. We therefore spoke with one person who received care from the service and three relatives. We also spoke with the registered manager, head of the service for the South East region and three care workers.

Updated 26 October 2018

We undertook an announced inspection of Helping Hands Harrow on 25 September 2018.

Helping Hands Harrow is a domiciliary care agency registered to provide personal care to people in their own homes. The service provides support to people of all ages and different abilities. At the time of inspection the service provided care to 25 people, five of whom received personal care. CQC only inspect the service received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

Our previous inspection in August 2017 found that there was no registered manager in post. The service took action in respect of this and this inspection in September 2018 found that 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.

The previous inspection on 17 August 2017 found two breaches of regulation. We rated the service as "requires improvement". During this inspection on 25 September 2018, we found that the service had made improvements in respect of risk assessments, medicines management, quality checks and audits.

Feedback indicated that people and relatives were satisfied with the care and services provided. One person we spoke with told us they were treated with respect and felt safe in the presence of care workers. Relatives we spoke with confirmed this.

Our previous inspection found a breach of regulation in respect of risk assessments. We found that the service did not always identify all potential risks and there was limited information contained in risk assessments. During this inspection in September 2018, we found that the service had taken appropriate action and made improvements in respect of this. We found appropriate risk assessments were in place and were personalised and included information specific to each person and their needs. Where people had specific health issues, there were appropriate risk assessments which included a summary of protective and preventative measures. These were also accompanied by an information fact sheet which provided details of specific health issues, warning signs and treatment.

Appropriate arrangements were in place in respect of medicines management. Records indicated that staff had received training on the administration of medicines and their competency was assessed. We noted that there were some gaps in medicine administration records (MARs). The service had a comprehensive system for auditing medicines. All the gaps in MARs had been clearly identified by these audits.

One person and relatives told us there were no issues with regards to care worker's punctuality and attendance. They told us that care workers were usually on time and if they were running late, the office contacted them to inform them of the delay. They told us that people experienced consistency in the care they received and had regular care workers.

At the time of the previous inspection in August 2017, the service did not have an electronic system for monitoring care worker's timekeeping and duration of their visit. During this inspection in September 2018, the service had a tele-logging system in place which flagged up if a care worker had not logged a call to indicate they had arrived at the person's home or that they were running late.

We looked at the recruitment records and found background checks for safer recruitment had been carried out to ensure staff were suitable to care for people.

One person we spoke with and relatives told us that care workers were caring and helpful. Staff were able to give us examples of how they ensured that they were respectful of people’s privacy and maintained their dignity. Staff told us they gave people privacy whilst they undertook aspects of personal care.

Systems and processes were in place to help protect people from the risk of harm and care workers demonstrated that they were aware of these. Care workers had received training in safeguarding adults and knew how to recognise and report any concerns or allegations of abuse.

One person and relatives told us that they were confident that care workers had the necessary knowledge and skills they needed to carry out their roles and responsibilities. Care workers spoke positively about their experiences working for the service. They told us that they received continuous support from management and morale amongst staff was good. Spot checks were in place to assess care worker's competency.

Our previous inspection found that there was a lack of consistency and the quality of care documentation varied. During this inspection in September 2018, we noted that the service had made improvements and ensured that care records were consistent.

Care support plans were individualised and addressed areas such as people’s personal care, what tasks needed to be done each day, time of visits, people’s needs and how these needs were to be met. They also included details of people’s preferences.

The service had a formal complaints procedure in place.

One person, relatives and care workers we spoke with were satisfied with the management at the service. They said that management were approachable and supportive.

Our previous inspection found the service did not have effective systems and processes in place to assess, monitor and improve the quality of the services provided. We previously found a breach of regulation in respect of this. During this inspection in September 2018, we found that the service had taken appropriate action and made improvements. The service had comprehensive MARs audits and checked care plans and risk assessments. The service also carried out regular staff spot checks and supervisions to monitor care workers. We also noted that the service had introduced an electronic tele-logging system to monitor staff punctuality and attendance.