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Archived: Hales Group Limited - Lowestoft Inadequate

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

Reports


Inspection carried out on 5 September 2018

During a routine inspection

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 carried out on 13 December 2017

During a routine inspection

The service provides personal care to people living in their own houses and flats in the community. At the time of the inspection the service was supporting 230 people. The service was given 48 hours’ notice of our inspection because the service provides a domiciliary care service and we needed to know that someone would be available. Hales Group Limited – Lowestoft is a domiciliary care service located in Lowestoft, Suffolk predominantly providing care to people in their own homes in Norfolk and Suffolk.

This announced inspection took place on 13 and 20 December 2017. On 13 December we visited three people, with their permission, in their own homes and the office location. On the next three dates we spoke with people by telephone in their own homes. This was the first comprehensive inspection we had undertaken at this location since the service was registered at this location with the Care Quality Commission (CQC) in January 2017.

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.

People and their relatives raised concerns with both late and missed visits. The care visit monitoring system was not effective to check if allocated visits were being completed as required and that staff were on time. Missed visits had also occurred, with family members being required to deliver care and this included personal care.

Staff had not always been deployed effectively to provide people with the support they required to meet their assessed care needs. During times of higher than expected staff sickness the senior staff managing the on-call service had not been able to meet everyone’s needs, despite attending care visits themselves. The result was late calls when staff arrived up to two hours late or missed calls when staff had not attended.

People did not always receive support to keep them safe. The late and missed visits meant that people were at risk of not receiving meals, medication or assistance with personal care.

Each person had a care plan and risk assessments were in place. Staff had received training in the administration of medicines. A duplicate copy of the records was maintained and kept securely at the service office. People’s care plans had been updated following changes to people’s care needs and reviews of their care.

Staff had received training in order that they had knowledge to meet people’s assessed needs and were supported with an appraisal and supervision.

Staff provided support to people to eat and drink as stated on their care plan. This included assistance with food preparation and providing people with snacks and drinks between calls.

People were 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.

People informed us the staff were kind and caring. Staff provided understanding to people when providing care but the service overall did not demonstrate that they cared for the people they supported at all times because of late and missed care call visits.

The service sent satisfaction questionnaires to people who used the service and their relatives, asking them for their views and opinions of the service they received.

There was a complaint’s procedure in place, this procedure enabled people to state if they were unhappy with the service. The people we spoke with were aware of how to make a complaint. The service also collated positive compliments that had been made based on people’s experiences.

The service had quality assurance systems in place that were not working well. The registered manager had introduced a new system for monitoring