Background to this inspection
Updated
20 December 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 two inspectors. An Expert by Experience supported the inspection making telephone calls to people and their relatives. 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 not a registered manager in post. A new manager was in post and was intending to submit an application to register.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was we needed to be sure that the provider or manager would be in the office to support the inspection.
Inspection activity started on 25 October 2022 and ended on 9 November 2022. We visited the location's office on 25 October 2022 and 3 November 2022.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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
We spoke with 2 family members and 6 people who used the service about their experience of the care provided. We spoke with 10 members of staff including the nominated individual, the operations manager, branch managers and care workers. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of care records and medicines records. We looked at 5 staff files in relation to recruitment and staff supervision and records relating to the management of the service. We reviewed a range of records off site including policies and procedures and monitoring systems.
Updated
20 December 2022
About the service
York- Hartley Care is a domiciliary care agency providing personal care to people in their own homes. The service provides support to younger adults, older people and people who may be living with dementia. At the time of our inspection there were 51 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
Governance systems were not sufficiently robust. Records were not always accurate, up to date or accessible. Information given during the inspection was not always accurate. Audits had not ensured the areas we identified at this inspection had been addressed.
Medicines were not managed safely. Medication records were not always completed in line with best practice and we could not be assured people had received their medicines as prescribed.
Improvements were required to support staff. This included, induction, training, competency assessments and supervision.
We could not be assured complaints were managed appropriately as records were not accessible. We have made a recommendation about this.
Risk assessments were not always in place, accurate or up to date. We have made a recommendation about this.
People were supported with their nutrition and health care where appropriate. Improvement was needed to ensure care plans were up to date in relation to areas that could affect people’s health such as weight loss.
People were supported by kind and caring staff who respected their privacy and dignity. People felt comfortable with the staff who supported them, and staff promoted their independence were appropriate.
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
This service was registered with us on 06 September 2021 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement and Recommendations
We have identified breaches in relation to medicines, staffing and governance at this inspection.
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.