Background to this inspection
Updated
28 May 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 was carried out by three inspectors. Two inspectors visited the office and a third made phone calls to people who received care from the agency.
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.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We reviewed all of the information we held about the service internally. This included notifications submitted to us relating to accidents, incidents or safeguarding concerns.
We used all of this information to plan our inspection.
During the inspection
We spoke with four people who used the service and two relatives about their experience of the care provided. We spoke with five members of staff including the registered manager, deputy manager and care workers.
We reviewed a range of records. This included eight people’s care records and medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures, were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and complaints.
Updated
28 May 2021
About the service
Third Hand Healthcare is a service providing care to people 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. At the time of our inspection, the agency was caring for 43 people, of which 35 received personal care.
People’s experience of using this service and what we found
People told us they felt safe with staff and that staff helped ensure any risks to their health or well-being were reduced. People said staff arrived on time and stayed the time they expected. They told us they did not feel staff rushed them. People confirmed staff were following national guidance around COVID-19 in that they always wore masks and gloves when providing care. In addition, people confirmed staff supported them with their medicines. We found staff were recruited safely and the agency reviewed and analysed incidents and accidents and learnt from them.
Where people were supported with their nutrition and hydration, they reported staff provided the support they needed. People were involved in developing their own care plans, which ensured they were enabled to make their own choices and decisions. People’s consent was sought before care was carried out and they told us they felt staff were competent in their role. 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; the policies and systems in the service supported this practice.
People’s care plans contained sufficient information to guide staff in relation to the care people required. There was evidence that staff also had social calls with people to reduce the risk of isolation, particularly during the COVID-19 pandemic. People told us they would have no hesitation contacting the agency if they had any concerns.
Management oversight of the agency was good. Improvements introduced at our last inspection had been embedded and sustained and there was a robust office team structure in place which helped ensure that people received a good service and staff felt supported. Management regularly reviewed the care people received and worked with external agencies to provide a holistic service.
Rating at last inspection and update
The last rating for this service was Requires Improvement (report published 25 January 2020).
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an announced comprehensive inspection of this service on 16 December 2019 when a breach of legal requirements was found in ‘Need for Consent’. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions, Safe, Effective, Responsive and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Third Hand Healthcare on our website at www.cqc.org.uk.
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.