Archived: Hazelbrook Specialist Care At Home

Updated 14 December 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 18 November 2017 and was announced. This meant that the registered provider knew we would be visiting.

The inspection team consisted of two adult social care inspectors and one expert by experience who made telephone calls to people and their relatives. An expert by experience is someone who has experience of this type of service.

We reviewed information we held about the service, including the notifications we had received from the provider. Notifications are reports about changes, events or incidents the provider is legally obliged to send us within required timescales.

The provider was asked to complete a provider information return [PIR]. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We used this to plan the inspection.

During the inspection we looked at seven care plans, and Medicine Administration Records (MARs) and daily records. We spoke with six members of care staff, plus the manager and the Chief Executive Officer (CEO). We looked at six staff files, including recruitment records. We spoke with five people and three relatives over the telephone prior to the office inspection day.

Updated 14 December 2017

This inspection took place on 18 October 2017. The inspection was announced which meant that we gave notice of our visit. This was because the location provides a domiciliary care service and we needed to be sure the manager would be available.

Hazelbrook Specialist Care at Home is a care agency providing palliative and end of life care to people in their own homes and works closely with a local hospice to give additional support to families and carers. At the time of inspection they were providing personal care to 25 people.

There was a manager in place who was in the process of becoming registered with the Care Quality Commission (CQC). 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.

We found that accurate records were not kept of administration of medicines. Medication administration records (MAR) had gaps where staff should sign to say the medicine was administered, no records or guidance for applying creams and care plans did not fully document people’s individual medicine needs.

Risks to people were not all recorded and action plans were not in place for staff to follow to minimise the risk.

Staff understood safeguarding issues, and felt confident to raise any concerns they had in order to keep people safe. Staff were able to tell us about different types of abuse and were aware of the action they should take if they suspected abuse was taking place. Staff were aware of whistle blowing procedures and all said they felt confident to report any concerns without fear of recrimination. However, not all staff were aware of how to raise a concern outside the organisation.

A number of recruitment checks were carried out before staff were employed to ensure they were suitable. However, not all the recruitment records were completed.

Staff had not received all the training they needed to carry out their roles effectively. Staff were not fully supported from supervisions.

Staff had a working knowledge of the principles of consent and the Mental Capacity Act and understood how this applied to supporting people in their own homes. Evidence of consent was not sought.

The service was set up specifically to provide palliative and end of life care to people; however they did not ensure appropriate care plans were in place for this.

We found there was sufficient staff employed to support people with their assessed needs .We were told that staff were kind and respectful; and staff we spoke with were aware of how to respect people’s privacy and dignity

We found care plans were confusing, repetitive and unorganised. There was no initial assessment, no record of care calls required or what care was needed at each call. Where someone had a care need this was documented as a problem.

The service had a complaints policy that was due for review in December 2016. Complaints were not fully documented.

There were no audit systems in place to monitor and improve the quality of the service provided.

We identified four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the registered provider to take at the back of the full version of the report.