Background to this inspection
Updated
19 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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 19 and 20 September 2018 and was announced. We gave the service five days’ notice of the inspection site visits because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in. Inspection site visit activity started on 19 September 2018 and ended on 20 September 2018. It included visits to two people who received a service in their homes. We also spoke with nine people who received a service and four relatives on the telephone. We visited the office location on 19 and 20 September 2018 to see the manager and office staff; and to review care records and policies and procedures.
The inspection was carried out by one inspector and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. Their area of expertise was in caring for older people, and people with dementia.
Before the inspection we asked the provider to complete a Provider Information Return (PIR). The PIR is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make. We also looked at information we had received about the service since it was registered, such as notifications about significant incidents, and information from people who use the service, staff, relatives and other professionals
On the first day of the inspection we visited the agency office where we met with the registered manager, three senior managers and two office staff. We looked at recruitment files, staff training records, staff supervision and monitoring records, staff weekly rotas and timetables sent to people each week to let them know who will be visiting. We looked at the electronic care planning system and daily records.
On the second day of the inspection we visited two people in their homes and also met two care staff who were supporting them at the time of our visit. We also returned to the agency office where we met a further two members of care staff.
Updated
19 October 2018
This inspection took place on 19 and 20 September 2018 and was announced. This was the first inspection since the service was registered.
Helping Hands (Exeter) Ltd is a domiciliary care service and provides personal care to people living in their own houses and flats in the community. They provide a service to older people, and people living with disabilities who require support with personal care and daily living tasks. The agency is based in Exeter and covers Exeter and the surrounding area. At the time of this inspection they provided personal care to 25 people. Not everyone using Helping Hands (Exeter) Ltd receives 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.
People told us they received a safe service. Care was taken to recruit the right staff for the job, and to check they were suitable. Staff received induction and regular training to ensure they were competent and able to carry out their roles safely and effectively. Comments included, “It’s a five-star service. I don’t think there have been any untoward incidents since the service started. People who select staff do a brilliant job”.
Staff knew how to identify and report any concerns about possible harm or abuse. They received training and information on how to recognise and report abuse and were confident any concerns would be addressed satisfactorily.
Before people received a service, an assessment was carried out to identify their needs. A care plan was drawn up and agreed with them. Potential risks to people’s health and safety were identified and staff knew how to support people to remain safe and well. Where people had been identified as being at risk of illness or injury, staff knew the actions they must take to reduce the risk of harm. People were supported to remain healthy. Care staff knew each person well, and understood their needs fully. They worked closely with health and social care professionals to ensure people received the right care and treatment. Consent to care and treatment was always sought in line with legislation and guidance.
People received a reliable service. There were sufficient staff employed to meet peoples’ needs and to ensure people did not experience missed visits. People told us they rarely, or never, received visits from care staff they did not know. Care staff always visited close to the expected time, stayed the correct length of time, and were never rushed.
People received safe support with their medicines. Staff were given information on each medicine to be administered and any risks. Staff were not allowed to administer medicines until they had received training and their competence had been checked and confirmed. Medicine administration records were completed accurately. A care staff told us, “It is a stipulation that you have to pass the training or you cannot provide the care”.
People told us they received a service that was effective. Comments from people we spoke with included, “I am very happy, it is such a relief to have people who pay attention and care”.
Staff were well trained and competent, well supported and supervised.
People received a service from staff, managers and providers who had an ethos of valuing and caring for people, and treating each person as a valued individual. People praised the staff team for their caring manner. Comments included, “I am very, very pleased – especially (the carer) I am having at the moment. She has made a huge difference to my life”.
People received a service that was responsive to their changing needs. They received care from a small team of regular care workers who knew them well. Staff understood each person’s individual needs. People told us they knew how to make a complaint and were confident any concerns or complaints would be listened to and acted upon.
People told us they received a service that was well-led. People, relatives and staff praised the registered manager and the office team for the way the service was managed. Comments included, “It seems to be well managed” and, “The service is efficient, and staff are well trained, courteous and competent”. There were good systems of communication throughout the organisation. The provider had systems in place to monitor all aspects of the service and make improvements where necessary. People were asked their views on the service and the provider acted on their suggestions. The provider and registered manager understood their responsibility to notify the Commission and other relevant organisations of any significant incidents or concerns. Incidents, complaints and grumbles were taken seriously, investigated, and actions were taken to prevent recurrence.
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