A Caring Hand Ltd

Updated 24 June 2023

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection team consisted of one inspector and one 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.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 24 hours’ notice of the inspection This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection. Inspection activity started on 26 March 2023 and ended on 5 April 2023. We visited the location’s office/service on 26 March 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During the inspection, we spoke with 8 people using the service, 4 people's relatives, 5 care staff, and the registered manager. We reviewed a range of records relating to people's care and the way the service was managed. These included care records for 5 people, staff training records, 5 staff recruitment files, quality assurance audits, incidents and accidents records, and records relating to the management of the service.

Updated 24 June 2023

About the service

A Caring Hand is a domiciliary care agency providing care to people in their own homes in the Oxfordshire area. At the time of our inspection there were 36 people receiving the regulated activity of personal care.

Not everyone using the service received personal care. CQC only inspects where people receive personal care, which 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

Systems were not always in place to ensure all documentation was accurate and up to date. Whilst there were some quality assurance checks carried out, these were not always effective to monitor and improve the service.

The provider had not always followed the required safe recruitment practices to help ensure suitable people were employed.

Staff did not always receive the correct training or support to carry out their jobs safely.

The provider had failed to ensure there were accurate and complete records in respect of each person, to evidence the care and treatment provided to them was in line with their assessed needs. There was limited information around peoples risks and what action to take to support people to safely manage these risks.

Relatives told us they felt their family members were provided with safe care and were happy with the service they were receiving.

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

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 2 February 2022) and there were breaches of regulation. The service remains rated as requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

At this inspection we found the provider remained in breach of regulation 17, 18, and 19.

Why we inspected

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

We received concerns in relation to the management of medicines and people’s care needs not always being adequately met. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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 remained the same based on the findings of this inspection.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for A Caring Hand on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to good governance, staffing, and fit and proper persons employed.

We have found evidence that the provider needs to make improvement. Please see the Safe and Well-Led sections of this full report.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.