Archived: Happy2Help

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.

Happy2Help is a domiciliary care agency. It provides personal care to people living in their own homes in and around the area of Filey. A service is provided to both older and younger adults and for people living with dementia or physical disabilities.

At the time of our inspection, the service supported 12 people.

There was a registered manager who had been in post since the service had registered and managed the service alongside the provider. 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.

The processes for ensuring that staff were suitable for the role of working with vulnerable adults were inadequate and incomplete. The provider had failed to complete their obligations to ensure that people employed were suitable and of good character. This placed vulnerable adults at risk.

Risk assessments were not in place for areas of identified risk. No information was recorded for staff to follow about how to reduce potential risks or the actions to take should the person deteriorate.

The management of medicines was not robust and there was no documentation to ensure people received medicines as prescribed by their GP. This put people at risk of harm.

Staff did not receive training essential to their role. Evidence of qualifications undertaken and training completed in previous roles had not been provided. Whilst staff told us they felt well supported by the management team they did not receive formal supervisions to discuss their well-being, training needs or to address any concerns.

Whilst care plans were in place, for all but one person, these lacked information about people’s needs, preferences, abilities and other important information about their lives. Care plans did not provide detail to guide staff on how to provide the support required and reviews had not been completed

There were no agreed systems to monitor the quality and safety of the service to ensure people received good care. Key policies and procedures relating to the running of the service were not in place.

You can see what action we told the provider to take at the back of the full version of the report.

Despite the information above, people told us they felt safe with the staff and were supported by a consistent and reliable team. Staff understood the actions to take to safeguard people from potential abuse and had access to Personal Protective Equipment (PPE).

Staff sought people’s consent before providing care and encouraged people to make decisions about their support. The staff team understood the importance of the Mental Capacity Act 2005 (MCA) but had not completed training in relation to this. An assessment was not completed for one person who was thought to lack capacity. Staff used daily records to describe the support provided to a person and any important information to follow-up on. People were supported to eat a diet of their choosing. Advice and input was sought from health and social care professionals when required.

People told us staff were kind and caring in their approach towards them. Staff upheld people’s dignity and privacy and spoke about people in a respectful manner. Information about advocacy services was available.

Staff had established a rapport with the people they supported and developed a good understanding of their needs. The provider had a compliments and complaints policy in place and people were confident that any issues would be addressed by the management team.

Staff and people who used the service provided positive feedback about the management team and found they were approachable and helpful. The provider and registered manager maintained regular contact with people and provided a service which was flexible to people’s needs.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying their terms of registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five questions it will no longer be in special measures.