Hopecare and Health Limited

Updated 12 August 2023

The inspection

We carried out this performance review and assessment under Section 46 of the Health and Social Care Act 2008 (the Act). We checked whether the provider was meeting the legal requirements of the regulations associated with the Act and looked at the quality of the service to provide a rating.

Unlike our standard approach to assessing performance, we did not physically visit the office of the location. This is a new approach we have introduced to reviewing and assessing performance of some care at home providers. Instead of visiting the office location we use technology such as electronic file sharing and video or phone calls to engage with people using the service and staff.

Inspection team

The inspection was carried out by 1 inspector and an 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 48 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.

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. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection.

During the inspection

This performance review and assessment was carried out without a visit to the location’s office. We used technology such as phone calls to enable us to engage with people using the service and staff, and electronic file sharing to enable us to review documentation. Inspection activity started on 13 July 2023 and ended on 17 July 2023. We spoke with 5 staff, including the registered manager, 2 people who used the service and 6 relatives. We reviewed 3 care records, 3 staff files and various records relating to medicines. We reviewed a range of records relating to the management of the service.

Updated 12 August 2023

About the service

Hopecare and Health Limited is a domiciliary care agency providing personal care to people in their own houses and flats. 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. At the time of our inspection there were 10 people using the service.

People’s experience of using this service and what we found

Not all risks posed to people were assessed. Some support plans were not in place to guide staff about how to safely support people. Risk assessments and care plans required some improvements, to ensure all risks to people were appropriately assessed and documented. Not all accidents and incidents were monitored, with lessons learned to mitigate future risks to people. People and relatives told us they felt safe.

Medicines records were not always accurately completed by staff and where people were prescribed ‘as required’ medicines, no protocols were in place to guide staff about how and when these should be taken. Staff received training and competency checks prior to administering medicines and people told us they were given their medicines as prescribed. Systems in place alerted the leadership team if medicines were not given on time.

Whilst staff had received training in a range of subjects, some staff required further training in the care certificate standards. We have made a recommendation about this. People were supported by enough staff, and call times were monitored by the registered manager. People told us staff supported them for their allocated times and where staff may have been late, this was communicated to them.

People were mostly 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. However, records relating to consent and capacity needed improving.

Governance systems required strengthening. Audits did not identify concerns found during the inspection, in relation to care records, learning from incidents, medicines records and capacity and consent. Quality assurance systems were not always effective. Feedback from people and staff had been sought. However, this was not used to as part of an ongoing improvement plan, to improve the quality of the service.

Staff were trained and knowledgeable about how to safeguard people from the risk of abuse. The registered manager was aware of their responsibilities to report notifiable incidents to external agencies. Staff told us they were supported by the registered manager and felt able to raise concerns.

Care plans contained details of peoples likes and dislikes, interests and hobbies. How people would like to progress was explored and documented, to enable staff to help people achieve their goals. Where people needed support to eat and drink, this was provided by staff and daily records contained details of people’s nutritional intake. Staff worked with external agencies, to ensure people's health needs were met, this included GP's, speech and language therapists, and district nurse teams.

People and relatives told us staff were friendly, kind and caring. Staff supported people in line with their choices and promoted privacy and dignity. People’s equality and diversity was explored at pre assessment stages. Staff completed daily records which were detailed and reflected how care was individualised and provided for people. Staff had access to an online system, which alerted them to any changes in people’s needs.

Complaints were appropriately investigated, responded to and actioned. Systems for monitoring complaints, included a 'you said, we did' report, to ensure action was taken to address concerns. We received positive feedback from people and relatives about the leadership of the service, they told us communication was good and they knew who to contact if they had any concerns. Staff had access to policies, procedures and care plans, and took part in regular meetings. Staff spot checks were in place to monitor staff performance, interactions, and practices.

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 4 March 2022 and this is the first inspection.

Enforcement and recommendations

We have identified breaches in relation to assessing risks and governance.

We have made a recommendation the provider reviews their training systems.

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 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.

This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and video and phone calls to engage with people using the service as part of this performance review and assessment.