Helping Hands - West Northumberland

Helping Hands - West Northumberland is a domiciliary care service providing personal care to a range of adults with a variety of health care needs, living in their own homes. At the time of the inspection, the provider supported 149 people.

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

Staff were kind and thoughtful and the vast majority of people and relatives would recommend the service to others.

Medicines were well managed and good infection control procedures were followed.

Care records were personalised and reflected people’s care needs and how these should be carried out. People and relatives were involved in planning their care and were supported to provide feedback about the service.

There were enough safely recruited staff to meet people's care needs. It was acknowledged at times recruitment had been difficult due to the nationwide shortages of care staff.

The provider worked well with other healthcare professionals to ensure people received good quality care. The management team checked the quality and safety of the service, with a range of audits and quality assurance checks in place.

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 requires improvement (published 26 April 2019).

At our last inspection we recommended the provider review office procedures in line with expected levels of customer care. At this inspection we found the provider had made improvements to address this.

Why we inspected

We undertook this focused inspection to check improvements had been made. This report only covers our findings in relation to the Key Questions, Safe, Responsive and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and video and phone calls to engage with people using the service as part of this performance review and assessment.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Helping Hands – West Northumberland on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

People’s experience of using this service: People and their relatives were very complimentary about the care provided by staff. Where issues with staff had arisen, they had been dealt with quickly. People were treated with kindness, respect and dignity.

Concerns were raised about the timings of visits and staff told us they needed more travel time between visits. The provider had recently installed a new system to address this, but it needed to be fully embedded.

People were involved and supported in the way they wanted. People felt safe with care staff visiting them and staff knew how to report any concerns.

People, relative and staff told us communication with the providers offices was not always good. The provider was aware of this and was working to improve matters with additional support and training. We have made a recommendation regarding this. Work with other healthcare professionals was proactive and positive.

Improvements had been made with medicines management, but we still found some issues regarding medicines records.

People were supported to have maximum choice and control of their lives and were supported in the least restrictive way possible. Staff encouraged people to maintain or regain their independence.

The provider monitored the quality and safety of the service through regular checks and audits.

Whilst we recognised the significant improvements the management team had made since our last inspection, the service had some areas which needed to further improve and be fully embedded and is therefore overall rated as requires improvement.

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

Rating at last inspection: Requires Improvement (Report published on 28 February 2018).

Why we inspected: The inspection was a planned inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

This service is a domiciliary care agency based in Hexham, Northumberland. It provides personal care and other additional support to people living in their own homes throughout the west of Northumberland. Services were provided to adults with a wide range of health and social care needs including physical disabilities, sensory impairments, learning disabilities, mental health needs and dementia. At the time of our inspection there were 244 people receiving a service.

Not everyone using Helping Hands – West Northumberland receives regulated activity. The Care Quality Commission (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.

The service had a registered manager in post. The registered manager has been in post since the service first registered on 13 November 2017. 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.

Medicine management had improved in some areas but we found further issues that needed to be addressed, including, for example, completion of medicine records and ordering procedures. The provider needed to fully embed best practice from the National Institute for Health and Care Excellence (NICE) guidelines.

People told us they felt safe and comfortable with the staff who visited them in their homes. They felt cared for by kind, compassionate and respectful staff. People were safeguarded from abuse as staff knew what to do if such an instance arose. Safeguarding incidents had been fully investigated and recorded with lessons learnt and shared.

Care staff supported people to maintain their health and welfare. Risk assessments had been carried out where risks had been identified. We saw these were regularly reviewed. Accidents and incidents were recorded and monitored for any trends and further discussed at senior management meetings for any future learning opportunities.

There were enough staff employed at the service, however further improvement needed to be made on rota systems, timings and continuity of staff to fully meet the needs of people who used the service.

There was still not a fully robust system to monitor missed calls as the provider relied upon staff or people to report these. However, the provider was in the process of introducing a new addition to their IT system to address this and this would be implemented by the end of June 2018.

There had been improvements in support provided to staff and this needed to be maintained. Staff told us they worked as a good team and felt able to speak up about issues that were important to them. We saw evidence of this in minutes viewed. Training had been provided but there were some gaps in staff records. A new internal trainer was about to be employed and plans for a robust package of training would be implemented immediately.

Recruitment of care staff was continuous to the needs of the business. Applications were requested, interviews held and successful applicants provided evidence so that employment checks could be undertaken appropriately.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Care staff supported people with their food and refreshment needs. People were content with the level of support received in this area with staff offering choice at meal times and monitoring intake, when necessary, to avoid malnutrition and dehydration. Healthcare professionals were involved when this was required, including GP’s and community nursing staff to maintain people’s health and wellbeing.

The people and relatives we spoke with told us that care workers were kind and friendly. Staff respected people’s homes and belongings. People said staff maintained their independence, privacy and dignity. The staff we spoke with all displayed a very caring approach and were extremely considerate when working with the people they cared for.

The care planning process had been reviewed with new paperwork implemented. We saw improvements had been made to the quality of people’s care records to ensure they were more person centred, although this still needed to be completed for everyone.

We saw all formal complaints had been logged and investigated in a timely manner. Less formal complaints had been logged but the provider needed to ensure that they were fully completed with outcomes. There was a complaints policy in place which was due to be approved by the board of directors.

The provider had a clear vision for the service and had introduced as part of this; rebranding, including new uniforms, new office environment, new website, new paperwork and a range of new processes. Additional staff had been employed in key roles and staff worked more together as a team.

We saw audits and checks of the service had been reviewed; existing procedures had been improved and new checks had been implemented. These were being embedded into practice and we have made a recommendation in connection with this area.

People had been given opportunities to feedback to the provider. A survey had been recently sent out to people and their families. This was in the process of being analysed. Feedback was also sought through care plan review meetings. Management had taken action where this was required, although needed to ensure actions were fully recorded.

We found one breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, in relation to safe care and treatment. We also made three recommendations, one in relation to scheduling systems, on in relation to audits and the other in relation to the accident and incident policy. You can see what action we told the provider to take at the back of the full version of the report.