Background to this inspection
Updated
9 August 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 25 July 2017 and was announced. The provider was given 48 hours’ notice of the inspection as we needed to be sure that the office was open and staff would be available to speak with us. The inspection was carried out by one inspector and one expert by experience who made phone calls to people who used the service. An expert by experience is a person who has personal experience of using or caring for someone whose uses this type of service.
Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at previous inspection reports and notifications about important events that had taken place in the service, which the provider is required to tell us by law. We used all this information to help us plan our inspection.
We visited the provider’s office in Dartford area of Kent. We spoke with the provider who is also the registered manager. We also spoke with four staff who were care workers. Following the inspection visit we spoke with six people who received support in their own homes from the provider.
During the inspection visit, we reviewed a variety of documents. These included three people’s care records, which included care plans, health care notes, risk assessments and daily records. We also looked at three staff recruitment files, records relating to the management of the service, such as staff training programmes, sample of audits, satisfaction surveys, staff rotas, policies and procedures.
We asked the provider to send additional information after the inspection visit, including training records and some contact telephone numbers. The information we requested was sent to us in a timely manner.
Updated
9 August 2017
The inspection was carried out on 25 July 2017, and was an announced inspection. The provider was given 48 hours’ notice of the inspection as we needed to be sure that the office was open and staff would be available to speak with us.
HLC Care Agency is a small family run domiciliary care agency which provides personal care and support for people living in their own homes. At the time of the inspection the service was providing personal care to 13 people.
There was a registered manager at the service. The registered manager was also the provider. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.
At our previous inspection on 05 July 2016, we found breaches of Regulation 17, Regulation 18 and Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider had failed to operate an effective quality assurance system and failed to maintain accurate records. The provider had not ensured that staff received appropriate training and professional development to meet people's needs. They had not provided appropriate support, supervision and appraisal as is necessary to enable staff to carry out the duties they were employed to perform. The provider failed to follow established recruitment procedures effectively.
The provider sent us an action plan on 28 July 2016 which showed they planned to make the changes and meet regulations by 20 October 2016.
The provider had suitable processes in place to safeguard people from different forms of abuse. Staff had been trained in safeguarding people and in the provider’s whistleblowing policy. They were confident that they could raise any matters of concern with the provider, or the local authority safeguarding team.
The provider provided sufficient numbers of staff to meet people’s needs and provide a flexible service.
The provider had robust recruitment practices in place. Applicants were assessed as suitable for their job roles. Refresher training was provided at regular intervals.
All staff received induction training which included essential subjects such as maintaining confidentiality, moving and handling, safeguarding adults and infection control. They worked alongside experienced staff and had their competency assessed before they were allowed to work on their own.
Procedures, training and guidance in relation to the Mental Capacity Act 2005 (MCA) were in place which included steps that staff should take to comply with legal requirements.
The provider carried out risk assessments when they visited people for the first time. Other assessments identified people’s specific health and care needs, their mental health needs, medicines management, and any equipment needed. Care was planned and agreed between the provider and the individual person concerned. Some people were supported by their family members to discuss their care needs, if this was their choice to do so.
People were supported with meal planning, preparation, eating and drinking. Staff supported people, by contacting the office to alert the provider to any identified health needs so that their doctor or nurse could be informed.
People said that they knew they could contact the provider at any time, and they felt confident about raising any concerns or other issues. The provider carried out spot checks to assess care staff’s work and procedures, with people’s prior agreement. This enabled people to get to know the provider.
Staff had received regular individual one to one supervision meetings and appraisals as specified in the provider’s policy.
Effective systems were in place to assess and monitor the quality of the service. There were formal checks in place to ensure that all records were up to date. Care plans and assessments had been consistently reviewed.
People spoke positively about the way the service was run. The management team and staff understood their respective roles and responsibilities. Staff told us that the provider was approachable and understanding.