Archived: Home Angels Healthcare Services Ltd

Home Angels Healthcare Services Ltd is a domiciliary care agency providing personal care to 29 older people living in their own homes. 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.

People’s experience of using this service and what we found

The provider did not have a registered manager in place. The previous registered manager left the service in February 2019. The service was currently being overseen by the nominated individual, who was appointed by the provider as main point of contact with CQC.

The service had recently undergone a change of ownership. People and staff fed back positively about the changes which had been made. There had been initial improvements made around care planning, staff training and safe staff recruitment.

People told us they were happy with the care they received. They said the service was reliable and safe. People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

There was an open culture at the service and systems were in place to promote ongoing improvement. The provider used technology to help monitor the quality and safety of the service, including an electronic rota management system.

People were treated with dignity and respect, which promoted their independence.

People were safeguarded against the risks of suffering abuse and avoidable harm. Risks associated with people’s care were assessed and effectively reduced. There were robust plans in place to reduce risks associated with emergencies, such as severe weather.

People’s care plans detailed the support they required in key areas such as nutrition, medicines and healthcare.

Care plans were developed and reviewed in partnership with people. When people’s needs changed, their care plans were reviewed, and the provider sought appropriate input from external health and social care professionals to help ensure people’s needs were met.

There were enough suitable staff in place to meet people’s needs. Senior staff were available to cover care calls when required. Staff were enthusiastic about their jobs and understood people’s needs and preferences. Staff received appropriate training and ongoing support in their role.

There were systems in place to deal appropriately with complaints and feedback and people gave us positive feedback about how the provider communicated with them about changes and updates.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 10 December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Home Angels Healthcare Services Ltd is a domiciliary care agency providing care and support to mostly older people who live in the community. At the time of our inspection there were 45 people using the service and receiving personal care.

The service had a registered manager. A registered manager is a person who has registered with the CQC 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 registered manager supported us during the inspection.

People felt safe while supported by the staff and relatives agreed their family member were safe. Staff had a good understanding of how to keep people safe and their responsibilities for reporting accidents, incidents or concerns. Staff had the knowledge and confidence to identify safeguarding concerns and acted on these to keep people safe.

People were supported by sufficient staff to meet their individual needs. However, some people told us they were not always informed about the changes to and timings of the visit. Safe recruitment practices were followed before new staff were employed to work with people. Checks were made to ensure staff were of good character and suitable for their role.

People were treated with respect and their privacy and dignity was promoted. People said their support workers were good and supported them in the way they wanted most of the time. Staff were responsive to the needs of the people they supported and enabled them to improve and/or maintain their independence with personal care. Risks to people’s personal safety were assessed and plans were in place to minimise those risks. There were safe medicines administration systems in place and people received their medicines when required. People's health and wellbeing was monitored and appropriate action was taken when required.

Staff training records indicated which training was considered mandatory by the provider. Most of the staff were up to date with their mandatory training. The registered manager had planned and booked training when necessary to ensure all staff had the appropriate knowledge to support people. Staff received supervision and appraisals to discuss various matters and review their performance.

People received support that was individualised to their specific needs. Their needs were monitored and support plans were kept under review and amended as changes occurred. People's rights to make their own decisions, where possible, were protected and staff were aware of their responsibilities to ensure people's rights were promoted.

Staff felt they worked well together and supported each other, which benefitted people. Staff felt management worked with them as a team most of the time though the communication could be improved at times. The registered manager was aware of the concerns and action was being taken to address this.

Quality assurance systems were in place to monitor the running of the service and the quality of the service being delivered. The registered manager continuously looked at ways to improve the service. They praised the staff team for their dedication and hard work and appreciated their contribution to ensure people received the best care and support.

We spoke with five people who use the service, five staff: the registered manager and the deputy manager. The focus of the inspection was to answer five key questions:

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found:

Is the service safe?

The service was safe. People who use the service told us they felt safe. Staff had received safeguarding training and knew how to recognise and deal with cases of suspected and actual abuse.

People's care plans had included full needs and risk assessments to ensure they were treated in a way that did not put them at risk of receiving inappropriate care.

All information and records relating to the service were kept either on a secure shared computer drive or in locked drawers. Only designated members of staff had access to specific types of information.

Is the service effective?

The service was effective. People told us they felt properly cared for and that staff were properly trained and competent to carry out their duties. Each person had a fully completed and up to date care plan which was tailored to their specific needs.

People's views were taken into account, for example through the use of regular satisfaction surveys, and staff also had the opportunity to give their feedback.

There were sufficient numbers of staff to provide an appropriate level of care to people. Care staff had either completed, or were in the process of completing, appropriate qualifications in health and social care.

Is the service caring?

The service was caring. People we spoke with were positive about the service they received. One person said: 'I'm very happy with my angel (staff).' and another said they thought the service was 'not bad' and that 'they do what I want them to do'. A third person said they thought the service was 'pretty good'. All the people we spoke with thought the staff were kind and friendly.

Care staff had a good awareness of people's needs. They were able to constantly monitor people's health and wellbeing and where necessary make amendments to a person's care plan.

Is the service responsive?

We found issues relating to punctuality of care staff's visits to people who use the service. All the people we spoke with said that staff had been late, sometimes on a regular basis, and often they were not informed about this. However, none of the people we spoke with said that a visit had ever been cancelled so they were always able to receive the care they needed.

Care plans were regularly updated to reflect changes in people's needs.

Is the service well led?

We found that the service was well led. The service had a registered manager. The provider regularly met with all staff to seek their views and to share any issues with them that might affect the service.

There were systems in place to monitor and assess the quality of the service on a regular basis. These included satisfaction surveys and a range of service audits.

The provider had revised the care plans to ensure accurate information was available. They had completed safe working practices, health and safety generic and individual risk assessments and revised or written policies and procedures , as necessary.

We found that people's needs were assessed and care was delivered in the way people wanted it to be. People told us that they were ''always treated with great respect and dignity'. People told us they 'always feel safe in staff hands, including when I'm being hoisted'.

We saw that the agency worked with other services for the benefit of those they offered care to. People said the agency ''keep us informed about our care package and tell us who to contact if we have any concerns about our future care'.

We found that the agency completed checks on new staff to make sure they were 'fit' to work with vulnerable people. Staff were supported to offer good quality care to people. People described care staff as, ''very good staff who know exactly what they're doing'.

The service had ways of checking that they maintained and improved the quality of care they offered. People said they had ''never had to make a complaint but would be confident to do so, if necessary'.

We found that the agency did not keep all the records that they should. Some records that they did keep were not accurate.