A Caring Hand Ltd

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.

A Caring Hand is a domiciliary Care service visiting people needing help with personal care in their own homes. At the time of the inspection, the service was supporting 34 people.

Not everyone who used the service received 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

Systems were not always in place or effective 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.

There were concerns that staffing levels were being affected by the challenges of recruiting new staff and staff sickness. Therefore, people sometimes had support and care from a range of staff. Although people were happy with the visits they received. The registered manager and other staff in senior roles were regularly supporting people in the community to ensure people always received a visit.

Staff received support and training to carry out their roles effectively. The registered manager was working to ensure all staff had regular spot checks and observations on their work.

People’s records were in the process of being reviewed as some contained conflicting information leading to uncertainty about the accuracy and relevance of the information. There were some good details about how people wanted to be supported and how they maintained their independence. Risks had been assessed to inform staff how to support people.

Feedback from people and relatives was mainly positive. They liked the staff who visited them, but we received comments on the lateness of some visits.

Complaints were responded to appropriately and people were asked for their views on the service so that improvements could be made.

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

This service was registered with us on 3 September 2020 and this is the first inspection.

Why we inspected

This was a planned inspection based on when the service was registered.

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 have identified a breach in relation to good governance at this inspection. 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.

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.