The Care Quality Commission (CQC) has rated a Staffordshire-based clinical homecare service inadequate and placed it in special measures, following an inspection which found people using the service had been harmed.
CQC inspected Healthcare at Home, which has its head office in Burton-on-Trent, in November and December.
Healthcare at Home provides care and treatment to people with chronic conditions – including Crohn's disease, haemophilia and HIV – in their own homes. At the time of the inspection, it delivered around 110,000 prescriptions a month.
CQC undertook the inspection following reports that people were not receiving their medicines on time or able to contact the service to raise concerns, as a result of a new computer system.
Following the inspection, CQC rated the service inadequate overall, and for being safe and well-led. It was rated requires improvement for being responsive to people’s needs and good for being effective. The service’s good rating for being caring is retained from its previous inspection.
The service was also placed in special measures. This means it is subject to close monitoring to help it improve its care and ensure patient safety.
If insufficient progress is made, CQC will use its enforcement powers further to protect patients from the risk of harm and hold the service’s leaders to account.
Inspectors found several shortfalls in the service, including:
- Unsuitable IT systems, leading to almost 10,000 missed medicine deliveries from October to December 2020. This meant some patients experienced avoidable harm and needed hospital treatment
- A failure to always investigate safety breaches and assess risk
- Poor record keeping, including regarding people’s allergies
- Insufficient governance, oversight and assurance systems to manage quality, performance and patient safety
- A failure to provide statutory notifications to CQC following service disruption
- A culture where patients, their families and staff were not empowered to raise concerns. Some patients reported fearing their medicine deliveries would be cancelled if they complained, and some staff reported fearing dismissal if they raised concerns or contacted CQC
However, inspectors identified some areas of good practice, including:
- Staff trained in key skills who received manager-led appraisals
- Instances where care and treatment were delivered in line with best practice, including when nurses administered chemotherapy
- Patients receiving regular health assessments and practical support to lead healthier lives
- Good infection control, including for COVID-19
- Staff knowledge of the service’s vision and values, teamwork and a focus on patient need and improvement.
Following the inspection, the service developed an action plan to drive improvement. It also communicated its plans to rebrand and implement a new patient app to CQC.
The service’s leaders also complied with a condition, imposed following the inspection, to provide regular performance reports to CQC. These reports indicated the performance of the service has improved since the inspection.
Full details of the inspection are given in the report published on our website.
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