Archived: Advantage Healthcare - Yorkshire

Interserve Healthcare - Yorkshire is a domiciliary care agency providing personal care to adults and children with complex health conditions and learning disabilities, living in their own homes. 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. During our first inspection visit, the service was caring for 32 people and 31 on our second inspection visit.

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

People were 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. Improvements were required in how the provider was recording relevant discussions and decisions about the care of people who lacked capacity to make decisions. We have made a recommendation for the provider to always complete these records and to consult relevant guidance and best practice in relation to the Mental Capacity Act 2005.

Staff provided people with a safe service. Accidents and incidents were recorded, investigated and analysed by the registered manager and changes implemented when required.

Risk assessments were in place to identify and manage risks to people and staff. There was after-hours support to assist staff when working on their own and out of office hours. Staff were knowledgeable about identifying and reporting safeguarding concerns.

Medication was administered safely.

People received support to maintain good nutrition and hydration and their healthcare needs were understood, met and relevant records kept. The provider kept in close contact with relevant healthcare professionals.

The service continued to have a positive impact on people’s lives. We received positive feedback from people using the service, their relatives and healthcare professionals about staff being kind and “going the extra mile”.

The provider was caring for people with very complex health conditions. Their care plans were detailed, and person centred; these were updated when required.

Complaints were well managed, and people and family members were confident that their complaint would be listened to and acted upon quickly.

There was an open and person-centred culture in the organisation. Staff enjoyed working for the provider and told us they felt well supported by a regular programme of training, assessment of competencies and supervision.

There were effective quality assurance processes in place that allowed management to keep an appropriate oversight of the care delivered, as well as implement and plan any improvements required. We received positive feedback about the registered manager being approachable and changes they had introduced.

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 in 24 January 2019).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Interserve Healthcare Yorkshire is a domiciliary care service that provides personal care to people living in their own homes. It provides a service to older adults in the Leeds area.

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 registered 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. The registered manager had only been in post a few months at the time of inspection.

Staff received ongoing training from the provider. New staff underwent induction training. However, training records showed some staff’s training records had lapsed.

The quality assurance systems showed how the service continually sought to improve, although, systems had not identified the areas of concern we raised at this inspection.

Care records sometimes lacked important details of how to support people in a specific way to meet their needs.

Staff spoke highly of the teamwork and how supportive colleagues were of each other. Supervisions and appraisals had not always been completed for some staff. We have made a recommendation about this in the report.

The provider had a clear policy and procedure in place for managing complaints. People felt able to raise any issues with any of the staff and were confident these would be addressed. However, we saw evidence some complaints had not followed the providers process.

People were safe as the staff team knew them well. Staff knew how to recognise and respond to any safeguarding concerns, and any learning from such incidents was shared with staff.

Staff made sure risk assessments were in place and took actions to minimise risks without taking away people's right to make decisions. People who had specific nutritional needs were supported to maintain a healthy diet.

People told us there were enough staff to help them when needed. Staff told us there were enough staff to provide safe care and support to people effectively. Advanced planning meant staffing levels were reviewed and reflected the needs of people who used the service.

People's medicines were managed in a safe way. When people required further intervention from medical professionals, staff knew the process to follow to help people with this.

Recruitment was appropriately managed as relevant background checks had been completed prior to employment, to ensure staff were safe to work with vulnerable people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The registered manager was aware of current procedures and guidance for best practice, and this was evident in the policies used at the service.

People told us staff understood confidentiality, dignity and respect. We were told staff were very committed to the people they cared for, building a good rapport and taking time to get to know them. Staff ensured people were treated with kindness and compassion, and provided significant emotional support when people became anxious. Privacy and dignity was promoted always.

It was evident the registered manager and their staff team were striving for the best outcomes for people who used the service through utilising the partnerships they had built up with external services.

Staff had a good knowledge of the prevention of infection and told us they were provide with personal protective equipment to use when working with people.

Further information is in the detailed findings below.