Health and Care at Home

Health and Care at Home is a community-based care provider that provides personal care to people living in their own homes. At the time of inspection 23 people were receiving a service and were in receipt of the regulated activity of 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

There were sufficient staff employed to cover the visits required by people.

Staff were provided with adequate travel time to enable them to carry out visits at the time of the person’s choosing.

Risks were identified, assessed and recorded. Environmental risks to visiting staff were also assessed.

Care plans were completed for each person and contained details of the person’s needs and preferences. Care plans were reviewed regularly to help ensure they were up to date and relevant.

People told us they felt safe when being supported by staff and were able to increase their independence in a way that felt comfortable for them. There were systems to help protect people from abuse and to investigate any allegations, incidents or accidents.

Recruitment processes were robust, and new staff had sufficient support during their induction before working alone with people.

There were robust auditing or monitoring processes in place at the time of this inspection. People were regularly asked for their views and experiences of the service provided.

The service had implemented effective quality assurance systems to monitor the quality and safety of the service provided. Spot checks were carried out to monitor staff performance. Staff were well supported and asked for their views.

People and their relatives spoke positively about staff and told us they were happy with the service they received. We were told staff were friendly, they were treated with kindness and compassion and their privacy and dignity was respected. Comments included, “They (Health and Care at Home) are exceptionally good. We have had two other companies and we were always having trouble with the previous ones. That’s how I know how good they are,” “It’s very well run. They are continuously improving and updating policies and procedures, maximising staff quality. I think they are sensitive. (Manager’s name) is lovely, they know what they are talking about, they are organised and very experienced,” “They are fantastic, I can’t fault them at all” and “They all ring me occasionally if there are any issues. Always polite, helpful. I know I can ring them if I needed to. The managers are lovely.”

People were supported by staff who had been appropriately trained and were skilled in their role.

People received support to maintain good health and were supported to maintain a balanced diet where this was part of their care plan.

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.

Staff understood the importance of respecting people's diverse needs and promoting independence. People were always asked for their consent prior to care being provided.

There were clear lines of responsibility which were known and understood by the staff team. Audits of all aspects of the service were completed by the registered manager.

There was a registered manager at the time of this inspection.

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 inspection for this service was rated requires improvement. (published 29 March 2022)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

Health and Care at Home is a community-based care provider that provides personal care to people living in their own homes. At the time of inspection 17 people were receiving a service and were in receipt of the regulated activity of 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

Risks were identified, assessed and recorded. Care plans were completed for each person and contained details of the person’s needs and preferences. However, all these records lacked some detail to direct staff on how to meet assessed needs. This was discussed with the provider. We were assured this would be addressed immediately. We have made a recommendation about this in the responsive section of this report.

There were sufficient staff to support people. Several new staff had recently joined the service. Recruitment procedures were not always robust, and some staff had been able to support people before all necessary checks and references had been obtained. The provider took immediate action to address this.

The service had recently experienced a period of unsettled management. This had impacted on the effective oversight and monitoring of the service. There were insufficient auditing or monitoring processes in place at the time of this inspection.

The service had not implemented effective quality assurance systems to monitor the quality and safety of the care provided. Spot checks were carried out to monitor staff performance however, these were not always clearly recorded or monitored. People and staff were asked for their views. Issues and suggestions had been raised. It was not clear if any action had been taken to address these.

People and their relatives spoke positively about staff and told us they were happy with the service they received. We were told staff were friendly, they were treated with kindness and compassion and their privacy and dignity was respected. Comments included, “It has all worked well for [person’s name] he’s being looked after at home and is chuffed to bits with that,” “Health and Care at home have changed my life. I get far more of the right kind of support from these carers than I’ve got from anyone previously. They are kind and patient, and I feel very honoured to have them” and “The carers are nice and gentle with [Person’s name]. They chat all the time with her and when they’re transferring her I can hear them constantly talking to her, reassuring and encouraging her.”

People told us they felt safe with staff. There were systems to help protect people from abuse and to investigate any allegations, incidents or accidents.

People were supported by staff who had been appropriately trained and were skilled in their role. Staff told us they felt well supported. Comments included, “The management are really supportive” and “Really good, never had such a good boss.”

People's care and support needs were assessed before they started using the service. People received support to maintain good health and were supported to maintain a balanced diet where this was part of their plan of care.

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. Staff understood the importance of respecting people's diverse needs and promoting independence. No one using the service, at this time, had any issues with their capacity, so no assessments had been required.

There was no registered manager at the time of this inspection. However, the current manager was in the process of registering with CQC.

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

Rating at last inspection

This service was registered with us on 22 August 2019 at a new location, and this is the first inspection at this location.

Why we inspected

This was a planned inspection for this service.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report. We found no evidence during this inspection that people were at risk of harm from this concern.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified a breach in relation to the oversight and governance of the service. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and 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.