Archived: Interserve Healthcare - Harrogate

Updated 27 June 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 checked 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.

We inspected Interserve Healthcare Harrogate on 27 March and 7 April 2017. This was an announced inspection. We gave the provider short notice (48 hours) that we would be visiting.

The inspection team consisted of one adult social care inspector on day one and two adult social care inspectors on day two. On day one we were supported by two experts-by-experience who had experience of domiciliary care. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The experts-by-experience made telephone calls to people who used the service and relatives to find out their views on the care and service they received.

Before the inspection we reviewed all the information we held about the service. This included information received via statutory notifications since the service was registered. Notifications are when providers send us information about certain changes, events or incidents that occur within the service, which they are required to do by law. We sought feedback from the local authority and NHS prior to the inspection. The provider completed 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 used all of this information to plan our inspection.

During the inspection we spoke with 11 people who used the service or their relatives/representatives. We spoke with the registered manager, regional manager; community programmes manager, branch nurse, one senior branch consultant, two nurses, one renal technician and two care workers. Following the inspection we spoke with the chief nurse who is also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We looked at ten people’s care records, including care planning documentation and medication records. We looked at eight staff files, including staff recruitment and supervision records, training records and records relating to the management of the service and a variety of policies and procedures developed and implemented by the provider.

Updated 27 June 2017

We inspected Interserve Healthcare Harrogate on 27 March and 7 April 2017. This was an announced inspection. We informed the provider at short notice (48 hours before) that we would be visiting to inspect. We did this because we wanted the registered manager to be present at the service on the day of the inspection to provide us with the information that we needed. The service was registered in November 2015 and this was the first inspection.

The service is registered to provide personal care and/or treatment of disease, disorder or injury to people living in their own homes. Children and adults were supported. The provider told us about three distinct types of service. First was support for nine people with complex healthcare needs in their own home. Second was renal dialysis support for seven people in their own home. And third was support for 17 people who required treatment through intravenous methods in their own home.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

As part of this inspection we found that the ‘home therapies’ (treatment through intravenous methods) was managed centrally by a team called community programmes. The registered manager did not have day to day management oversight of this service. Following the inspection the nominated individual told us they had implemented systems for the registered manager to communicate with the community programmes team. They had also started to work with the CQC registration team to look at future registration options which may suit this model of service.

Quality assurance systems in place were not always effective in highlighting areas for improvement. We made a recommendation that the provider reviewed their systems to ensure they captured areas which may need improvement.

Systems in place to manage people’s medicines did not incorporate all good practice. We made a recommendation that the provider review their policy to incorporate good practice guidance. The nominated individual told us they would do this following the inspection.

Staff told us that the registered manager was supportive and that there was a positive culture within the team. We saw records to confirm staff had received appropriate supervision, appraisal and training to enable them to fulfil their role.

Assessments were undertaken to identify people’s care needs. Not every area assessed was always transferred into a care plan or risk assessed for staff to have access to robust information to perform their role. This included person-centred details about how a person preferred to be supported. Staff were aware of people’s likes and dislikes and people told us they felt well cared for. However, recording all details known would support staff to build and develop positive relationships with people and provide consistency.

Staff worked very well with other healthcare professionals to support people. This included support with nutrition and hydration needs. People who required clinical support were supported in line with professional’s advice. Staff understood people’s clinical needs and how to deal with emergencies. Emergency protocols were not always recorded for staff to follow. This was something the registered manager agreed would support the knowledge staff received in training to increase their confidence if such emergencies arose. They agreed to include them in care plans in the future.

There were enough staff employed to provide support and ensure that people’s needs were met. People receiving a service had been involved where possible in the recruitment of staff. We saw that in the main people received support from a consistent team of care workers. Effective recruitment and selection procedures were in place and we saw that appropriate checks had been undertaken before staff began work.

There were systems and processes in place to protect people from the risk of harm. Staff were aware of the different types of abuse and what would constitute poor practice. Staff followed the principles of the Mental Capacity Act 2005 and empowered people to make their own decisions.

People and relatives told us that staff treated people with dignity and respect. Staff spoke with compassion when discussing the people they cared for. People and their relatives told us members of staff knew them well and often went over and above to support their needs very well.

The provider had a system in place for responding to people’s concerns and complaints. People told us they knew how to complain and felt confident that staff would respond and take action to support them.