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Archived: Help at Home care service

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Inspection report

Date of Inspection: 2 January 2014
Date of Publication: 4 February 2014
Inspection Report published 04 February 2014 PDF | 77.09 KB

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 2 January 2014, checked how people were cared for at each stage of their treatment and care and talked with people who use the service. We talked with carers and / or family members, talked with staff and reviewed information given to us by the provider.

Our judgement

People experienced care, treatment and support that met their needs and protected their rights.

Reasons for our judgement

We spoke with four people who received a service from Help at Home, and one person’s representative. They told us “they do whatever I ask of them” and “it is a very good service”. All the people we spoke with confirmed their needs were met by the care staff.

We reviewed the care plans for three people. In each file we saw the exact times the person wanted to be visited, duration and on which day(s). We checked these details against the daily notes recorded by the care staff at each visit. The times mostly matched. One person who received a service told us “they are sometimes a bit late but that is usually for a very good reason such as the previous person to me has been unwell or something, it could be me one day”.

The daily notes we saw were detailed, factual, dated, timed and signed by the care staff and were mostly legible. These records were returned to the office for auditing and storage on a monthly basis.

Staff we spoke with told us they found the care plans were sufficiently detailed to inform and direct them as to the support needed by the person. Staff confirmed, and we saw, the care plans were regularly reviewed in order to take account of any changes that may have occurred.

The provider might like to note the initial care plans, created at the beginning of a period of support for a person were not dated. Therefore, it was not clear to the reader when the assessment had been carried out. However, all subsequent care plan reviews we saw had been clearly dated.

Risk assessments are a tool to identify hazards and the action that staff must take to reduce the risk from the hazard. We saw risk assessments had been completed in all the files we reviewed and these had been updated. Staff we spoke with confirmed such risk assessments were appropriate, accurate and regularly reviewed.

We saw, in one person’s care file, food and fluid intake was to be monitored by care staff due to concerns regarding nutritional intake and possible weight loss. We reviewed the records for this monitoring and saw there were gaps were care staff had not recorded food and fluid intake. The entries we saw were not sufficiently detailed in order to inform the registered manager, who was reviewing such records, if the person had eaten sufficient quantities. For example, the records stated the person had eaten “custard” and “Soup” on several occasions, but did not state the quantity that had been eaten by the person. The provider might like to note such records should be accurate and detailed if they are to perform their function and effectively inform the reviewer if any action should be taken.

People’s life histories, their hobbies or their end of life wishes were not clear in the care plans we reviewed. It is important such information is gained so staff can understand a person's past and how it can impact on who they are today, together with details of their choices and preferences. This information supports staff to provide person centred care.

In one care plan we saw visit times had been altered recently in order to meet the needs of the person. For example, the person wished to access the local community, and we saw two visits were brought together to allow the carer sufficient time to support the person to go out in the car. This demonstrated the service was flexible when meeting people’s needs.

We reviewed the policies and procedures stored on computer at the office of Help at Home. Most of these policies were dated October 2013 and the registered manager told us they were in the process of reviewing all policies. We did not see a specific policy detailing the action required should adverse weather affect business as usual. The registered manager informed us the service had a priority list of the most vulnerable and those without family/friends who could support them in the absence of carers who may not be able to reach them, for example, following heavy snow fall. We were told these people would be reached