Hilltop Works

Updated 27 October 2022

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

This inspection was carried out by one inspector.

Service and service type

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

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was a registered manager in post, who was also the provider.

Notice of inspection

The first site visit for the inspection was unannounced. However, the second site visit was announced to ensure there would be someone available in the office.

Inspection activity started on 16 May 2022 and ended on 16 September 2022. We visited the location’s office on 25 May 2022 and 09 September 2022.

What we did before the inspection

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 reviewed information we had received about the service from a variety of sources including notifications received from the provider (events which happened in the service that the provider is required to us about). We sought feedback from the local authority. We used all of this information to plan our inspection.

During the inspection

We visited the office location to review written records. We looked at 12 staff files in relation to recruitment. We reviewed a range of records, including five people's care records and medication records. We checked records relating to the management of the service including policies and procedures and quality assurance records.

We spoke with five people who used the service. We spoke with seven staff members, including the provider, care coordinator, senior carer and care workers.

Updated 27 October 2022

About the service

Suite 8 Old Anglo House is a domiciliary care agency providing personal care. The service provides support to people living in their own homes. At the time of our inspection there were 15 people using the service.

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

The provider had failed to operate robust recruitment procedures, including undertaking relevant checks on prospective staff. People's care plans and risk assessments were not always regularly updated. The provider failed to ensure the service was being managed effectively and failed to ensure comprehensive quality and safety monitoring. Medicine management was not always safe as records were not always in place and checked regarding people's current prescribed medicines.

We have made recommendations about the recruitment and training of staff.

Most people told us they were not aware of the content of their care plan and did not have a copy. This meant people were not always fully involved in making decisions about their care. Staff supported people to maintain relationships that mattered to them, such as family, community and other social links.

People told us they felt safe whilst receiving care from staff. People's privacy and dignity were respected, and independence encouraged. People did not feel rushed by staff while they were receiving personal care.

People told us they felt staff were well trained. People felt staff supported them with maintaining a good quality of life. People were supported with their nutrition and hydration when this was required. People told us they were happy with the support they received to eat and drink. Staff knew what they needed to do to make sure decisions were taken in people's best interests and involved the right professionals or next of kin when needed.

People received support from kind and caring staff. People told us they, or their relatives, were involved in making initial decisions about the care they received.

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 rating for this service at their previous premises was good (published 29 December 2016).

Why we inspected

The inspection was prompted in part due to concerns received about the service operating outside of their registration. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well-led sections of this full report.

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

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

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 and will take further action if needed.

We have identified breaches in relation to the provider’s recruitment practices and the leadership of the service at this inspection.

You can see what enforcement action we have taken at the end of this report.

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 return as per our re-inspection programme. If we receive any concerning information we may inspect sooner.