Background to this inspection
Updated
4 September 2021
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 Care Act 2014.
Inspection team
The inspection team was made up of two inspectors 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.
The service had a manager registered with the Care Quality Commission. 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. The registered manager was also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure that the registered manager would be in the office to support the inspection.
Inspection activity started on 21 July 2021 and ended on 5 August 2021. We visited the office location on 4 August 2021.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and Healthwatch for both Sheffield and Barnsley. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
We used all of this information to plan our inspection.
During the inspection
We spoke with two people who used the service and eight of their relatives about their experience of the care provided. We met with the registered manager. We spoke with nine members of care staff.
We looked at written records, which included four people’s care records and three staff files. A variety of records relating to the management of the service were reviewed.
After the inspection
We continued to seek clarification from the registered manager to validate evidence found. This included reviewing policies and procedures.
Updated
4 September 2021
About the service
Hallam24 Healthcare is a domiciliary care service which provides personal care to adults with a range of support needs in their own homes. At the time of this inspection the service was supporting 29 people.
People’s experience of using this service and what we found
Risks to people had not been fully assessed. There was not always guidance for staff on how to best manage risks. Accidents and incidents were not analysed, which meant staff could not learn from these events. The systems in place to ensure people received their medicines as prescribed were not effective.
Care records did not always contain an accurate assessment of all of people’s care and support needs. Care records were not always person-centred. Effective systems had not been established for identifying, receiving, recording, handling and responding to complaints.
The registered manager had not acted on most of the recommendations made at our last inspection. In addition, at this inspection we identified new concerns with regard to medicines management and complaints. The registered manager had not established effective quality assurance processes. They did have some audits in place, however these had not identified the issues we found during this inspection.
The provider had effective recruitment procedures in place to make sure staff had the required skills and were of suitable character and background. Staff understood what it meant to protect people from abuse. Most people told us staff were kind and caring. The provider had policies and procedures which reflected current legislation and good practice guidance.
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 was requires improvement (published 12 April 2019). The service remains rated requires improvement. This service has been rated requires improvement for the last two inspections.
Why we inspected
We received concerns in relation to the management of the service. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has remained requires improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvement.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hallam24 Healthcare on our website at www.cqc.org.uk
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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to good governance, management of medicines and responding to complaints. 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 for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authorities to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.