13 July 2023
During a routine inspection
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.