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Archived: Hales Group Limited - Lowestoft Inadequate

This service was previously registered at a different address - see old profile

Inspection Summary


Overall summary & rating

Inadequate

Updated 7 December 2018

This inspection took place on 5 and 6 September 2018, and was announced.

At our last inspection in 13 and 20 December 2017 and 4, 11, and 15 January 2018, we found breaches of legal requirements in relation to safe care and treatment, staffing and governance of the service. We met with the provider to confirm what they would do and by when to improve the key questions to at least good. They sent us an action plan detailing how systems and processes would be improved to enhance the delivery of care.

At this inspection in September 2018, we found that although new systems and processes had been implemented, sufficient improvement had not been made, and people continued to receive care which was not responsive and did not always meet their assessed needs. We found three repeated breaches of regulations in relation to safe care and treatment, staffing, and governance. We also found two new breaches in relation to safeguarding and notification of events.

Hales Group Limited - Lowestoft is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community [and specialist housing]. It provides a service to older adults, people living with dementia, mental health conditions, and physical and sensory impairments. At the time of this inspection, the service was supporting 69 people. Not everyone using Hales Group Limited – Lowestoft receives the 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 take into account any wider social care provided.

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.

Since our last inspection, the service had made changes to the Lowestoft branch and how they delivered care geographically. The Lowestoft branch now delivers care only to people living in the Waveney area. This means they now support a reduced number of people (69 at the time of this inspection). At our previous inspection on 13 and 20 December 2017 and 4, 11, and 15 January 2018, they were supporting 230 people.

Despite the reduction in the number of people they supported, we found that people were still receiving late visits. Some people had cancelled their care as they couldn’t wait any longer for the carer to arrive. Since our last inspection there have also been missed visits. This meant that people did not always receive the care they needed to keep them safe.

Some people required two staff to attend to their needs, but in some cases, we found that only one carer had attended. This placed people and staff at risk of harm and did not meet the person’s assessed care needs. Some relatives told us that they helped the carer to deliver the care their relative needed in the absence of the second carer.

Feedback we received from some people using the service and their relatives indicated that they did not have confidence in the service delivering the care as planned. Others felt that the care was safely delivered. People told us that carers delivering their care were kind and caring, but they did not feel that office staff and management could be relied upon.

New auditing processes had been introduced, though not all quality checks were effective, and some concerns had been missed such as the recording of medicines and length of care visits.

Safeguarding procedures were not understood or followed when one person was found to be at risk of harm. Staff had not reported obvious risks to the person, and others who may visit them in their home. The service had not understood their duty of care.

There was a complaints process in place,

Inspection areas

Safe

Inadequate

Updated 7 December 2018

The service was not safe.

People continued to experience missed and late visits. People�s assessed needs were not always met due to errors in communication and scheduling of visits.

The service had not recognised when a person was at risk, and had not taken action to safeguard them.

Staffing levels were not sufficient to support the care delivered. Staff sickness contributed to poor care delivery.

Effective

Requires improvement

Updated 7 December 2018

The service was not consistently effective.

People did not always receive the full length of time on their allocated visits, in line with their assessed needs and best practice.

The service was working in line with the Mental Capacity Act. There were systems in place to assess people's mental capacity.

People�s care records contained information on any nutritional support. Some areas required further clarification to ensure guidance was clear for staff.

Caring

Requires improvement

Updated 7 December 2018

The service was not consistently caring.

People�s feedback indicated that they did not always benefit from a caring culture.

Carers were reported to be kind and caring.

Responsive

Requires improvement

Updated 7 December 2018

The service was not consistently responsive.

There was a complaints procedure in place, however, people were not always confident that these were acted on and that things improved as a result.

Staff developed care plans with people to meet their needs. The service was rolling out a review of care plans as it introduced a new format document. Care plans included the level of support people needed and what they could manage to do independently.

Well-led

Inadequate

Updated 7 December 2018

The service was not well-led.

Feedback from people and their relatives indicated that they did not feel confident that the service would deliver the care they needed at the right time.

Not all notifiable incidents had been reported to the Care Quality Commission as required by law.

Auditing processes had not identified all issues in relation to people�s care.

People, relatives, and social care professionals told us that the management team at times were slow to respond to concerns raised, and communication required improvement.