Pure Heart Homecare Ltd

Updated 6 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection team consisted of 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 in the community. It provides a service to people in the Outwell, Downham Market and Wisbech areas. At the time of our inspection 24 people were using the service.

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.

Notice of inspection

We gave the service 48 hours’ notice of the inspection visit because it is small and the registered manager is sometimes out of the office supporting staff or providing care. We needed to be sure that someone would be in.

Inspection site visit activity started on 11 April 2019 and ended on 17 April 2019. It included visits and telephone calls to people who used the service and their relatives. We visited the office location on 11 April 2019 to see the manager and to review records, policies and procedures. We also carried out a final visit to the office on 17 April 2019 to provide and discuss our feedback with the registered manager.

What we did:

We used the information the provider sent us in the Provider Information Return (PIR). This is information providers send to us to give some key information about the service, what the service does well and improvements they plan to make. We looked at other information we held about the service including notifications which relate to significant events the service is required to tell us about.

During the inspection we spoke with four people who used the service, three relatives, two directors, one of whom was also the registered manager and four members of the care staff. We reviewed four care plans, two medication administration records and looked at three staff files which documented recruitment procedures and ongoing support for staff. We also reviewed rotas, staff training records and other documents relating to the safety and quality of the service.

Updated 6 June 2019

About the service:

Pure Heart Homecare Ltd is a domiciliary care agency which provides personal care and support to people in their own houses and flats in the community. It provides a service to older and younger adults, some of whom are living with dementia or have a disability. Not everyone using Pure Heart Homecare 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. At the time of our inspection the service was providing personal care to 24 people.

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.

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

People’s experience of using this service:

The provider had systems in place to monitor the quality and safety of the service. In most areas of the service this worked well. However, medicines were not well managed. The provider had not recognised that the support they were giving people to take their medicines met the threshold to be regarded as medicines administration. This meant that all staff would need to have medicines training and competency assessments and that care plans needed to accurately reflect the support required. The provider had not done this and this placed people at potential risk of harm. They had also failed to adequately risk assess a specific issue with regard to medicines. This also placed people at potential risk of harm. Poor management of these issues meant that there were breaches of regulation with regard to medicines management and good governance.

The provider had assessed and managed other risks well. Staff understood their responsibilities with regard to keeping people safe from abuse and knew how to raise concerns if they needed to.

People, and their relatives, were very happy with the care and support provided. People felt safe and relied on Pure Heart to provide staff who had the skills and knowledge needed and who attended on time. There were systems in place to ensure people did not miss their calls and people received consistent care and support from staff who had received appropriate training.

The registered manager carried out person centred assessments of people’s needs and preferences. Care plans were clear and information was easily accessed by staff.

People, or their relatives, consented to their care and were able to express their preferences with regard to how their care was delivered. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems of the service supported this practice.

People were very positive about the kindness and reliability of the staff, with some being highly praised. Several people told us they would recommend Pure Heart to friends or other family members as they held it in high regard.

The provider consulted people who used the service about their care and addressed people’s informal concerns well. Formal complaints were responded to in a timely manner and to people’s satisfaction.

The provider had good oversight of the day to day running of the service. They were honest and open about the issues relating to medicines we identified and began to address them as soon as we raised them. We were assured by their positive attitude which demonstrated a strong desire to improve and develop the service.

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

Why we inspected:

This inspection was carried out as part of our regulatory schedule. It was the first inspection since this service was registered with CQC on 29 March 2018.

Please see the action we have told the provider to take section towards the end of the report

Follow up:

We have issued requirement notices for two breaches of regulation. We will require the provider to send us an action plan detailing how they will make the necessary changes and in what timeframe they intend to do this. We will carry out another inspection in the future to check if the improvements have been made and sustained.