Archived: Huggies Cares Ltd

Updated 30 April 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

The inspection took place on 3, 4 and 5 January 2018 and included telephone calls and visits to people’s homes. The provider was given 24 hours’ notice because the location is a small domiciliary care service and we needed to be sure that a manager would be in to facilitate our visit.

The inspection was carried out by one adult social care inspector and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. On this occasion the expert-by-experience had experience in caring for an older person who has used care services.

Before the inspection, we asked the provider 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 also looked at information we held about the service including previous inspection reports and notifications. A notification is information about important events which the service is required to send us by law. We asked and received information from Trafford local authority contracts, commissioning and safeguarding teams. They did not raise any concerns with us.

We contacted Healthwatch but they did not have any information about this service. Healthwatch is an organisation responsible for ensuring the voice of users of health and care services are heard by those commissioning, delivering and regulating services.

With their prior consent, we visited two people and one relative in their homes and we spoke with two people and three relatives by telephone. We also spoke with the manager, human resources and finance officers and two care staff. We looked at records relating to the service, including six care records, daily record sheets and medication administration records (MARS) and four staff recruitment files.

Updated 30 April 2019

The inspection took place on January 3, 4 and 5, 2018 and was announced. At the last inspection in October 2016, we asked the provider to make improvements in recruitment processes, induction, training and professional support for staff, providing person centred care, following the requirements of the Mental Capacity Act and quality assurance systems. We found not all areas had been improved to meet the relevant requirements. Following that inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question(s) Safe, Effective, Response and Well Led to at least good.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing. It provides a service to older adults with a variety of needs. Support provided includes assistance with personal care, domestic tasks and outings into the community. At the time of this inspection the service supported 34 people.

The service did not have a registered manager since December 2016. 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 of the Health and Social Care Act 2008 and associated Regulations about how the service is run. We checked our records at the time of this inspection and found the manager’s application was hindered by an address error on their registration certificate. This meant they were unable to proceed with their registration until this error had been resolved. We will make further checks to ensure their registration is completed.

We found five breaches of the Health and Social Care Act regulations in relation to recruitment processes, staffing training, care records, the management of complaints, acting on feedback and quality assurance processes. You can see what action we told the provider to take at the back of the full version of the report.

We made two recommendations that the provider implements effective systems for monitoring accidents and incidents and for safeguarding people’s rights in line with the Mental Capacity Act.

We found the service was not safe in some respects though people told us they felt safe. People were supported by a regular staff team and the provider had suitable systems in place to take action to protect people from abuse.

Where needed, people were supported to take their medicines in a safe way. We identified concerns regarding medication administration training and competency checks. This meant people were potentially at risk because staff did not have the right skills and experience.

Missed visits were rare but staff were often late for their visits. This meant people did not consistently receive care and support as agreed and in line with their needs.

Recruitment processes were not sufficiently robust. This was a continued breach of the relevant regulation and meant people were not protected from risk of unsuitable staff being employed.

People were protected from risk, including risk of infection, because appropriate assessments and prevention measures were in place to help ensure people were supported safely.

The service was not always effective because staff did not receive a robust induction, training relevant to their role or appropriate professional support. This meant people were at risk because staff had not received the necessary skills to do their job effectively.

Improvements had been made in ensuring the service met the requirements of the Mental Capacity Act 2005. However, we found inconsistencies in how the provider followed the MCA and recommended a more effective system be put in place to protect people’s rights.

People and relatives said staff’s approach was caring and empathetic, and that they were treated with dignity and respect. Staff carried out their duties in a responsible and professional manner and demonstrated they knew the people they supported well.

People gave us examples of how staff encouraged them to be independent according to their abilities. Staff we spoke with confirmed this. This helped to promote people’s general good health and wellbeing.

The service operated within a diverse and multicultural community and had systems in place to ensure people’s equality and diversity needs were recognised.

The service was not consistently responsive. While improvements had been made in reviewing support plans so they were fit for purpose, we noted some care records were not in place or did not contain complete information about people’s needs or conditions.

While the service had procedures in place to manage complaints and concerns raised, the manager was unable to provide us with documentary evidence on how they had managed two recent complaints relating to the timing of visits and gender preference of staff attending visits.

Support plans in place contained detailed person-centred information providing staff with adequate information to help staff support people responsively.

We found the service was not consistently well led. The service was without a registered manager since December 2016. Quality monitoring processes were insufficiently robust and had not identified concerns we found during our inspection. This was a continued breach of the regulation and meant people were potentially at risk because the quality of care provided was not effectively monitored.

Some improvements had been made in relation to seeking feedback from people and their relatives. We also saw the manager had asked staff to appraise the performance of the management team. The manager had not yet developed a plan of action to make the improvements suggested by people, relatives and staff.

Staff told us the management team was approachable and supportive, and that regular staff meetings were held. This helped to ensure staff had the opportunity to raise any concerns they may have about their work and appropriate guidance to follow.