Background to this inspection
Updated
14 June 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
This inspection was completed by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. During the inspection the registered manager told us of their intention to leave. They left shortly after our inspection and have submitted an application to de-register.
Notice of inspection
This inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 23 April 2019 and ended on 3 May 2019. We visited the office location on 23 and 30 April 2019.
What we did before the inspection
We reviewed information we had received about the service from the provider since the last inspection, such as notifications which the service is legally required to send us. We received feedback from the local authority. We used this information to plan our inspection.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with two people who used the service and three relatives about their experience of the care provided. We spoke with four members of staff including the provider, registered manager, care co-ordinator and a care worker. We reviewed a range of records for three people and medicine administration records. We looked at a selection of records relating to the recruitment and support of the staff team and the management and running of the service.
After the inspection
We continued to liaise with the provider about the actions taken since the inspection to ensure people were safe. We reviewed information about the policies and procedures and other information relating to the running of the service.
Updated
14 June 2019
About the service
Happy2Help is a domiciliary agency providing personal care support to people who live in and around the Filey area. At the time of the inspection the service supported 15 people, both older and younger.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of our inspection, 12 people were in receipt of a regulated activity.
People’s experience of using this service and what we found
Risk assessments did not provide enough information to guide staff about what actions to take to try and reduce potential risks for people. These assessments were not always updated to reflect people’s current needs. We could not be confident people always received their medicines as prescribed because records were not fully completed and there was limited information about the support people needed to take their medicines.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People told us they received support from a consistent team of staff who understood how to care for them. Staff asked for the help and advice of health and social care professionals when required.
Staff had not always completed a thorough induction to demonstrate they had the right skills and knowledge to care for people. Staff had not always completed some important parts of their training such as safeguarding and food hygiene. This meant people could be at risk from receiving support from a staff team who did not have sufficient knowledge.
People told us staff were kind and caring. Staff promoted people’s dignity and knew the people they supported.
Care plans were completed but these did not always provide enough information to guide staff on the support people required. Reviews of people’s support were completed to ensure they were happy with the support being provided.
We have made a recommendation for the provider to understand and apply the Accessible Information Standards.
Checks were completed of the quality and safety of the service, but these had not effectively highlighted the issues we found during this inspection. The provider did not have sufficient knowledge of legislation and best practice to drive improvements within the service. People’s feedback was sought about the service and people told us they felt confident in approaching the management team with any issues. A relative told us, “The service is very good; excellent in every way”
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was inadequate (report published 23 October 2018) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection the provider was still in breach of regulations.
This service has been in Special Measures since 23 October 2019. Following this inspection there no longer any inadequate rating overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches in relation to safe care and treatment, staffing and the governance of the service at this inspection.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.