Background to this inspection
Updated
25 August 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
This inspection was carried out by an inspector 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 homes.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 12 July 2021 and ended on 15 July 2021. We visited the office location on 12 July 2021.
What we did before the inspection
We reviewed information we had received about the service since the last 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 used all of this information to plan our inspection.
During the inspection
We spoke with the registered manager and a staff member. We reviewed a range of records. This included three people’s care records and medication records. We looked at three staff files in relation to recruitment and sampled staff supervision. A variety of records relating to the management of the service, including meeting minutes and audits were also reviewed.
After the inspection
We spoke with 10 people who use the service and five relatives. We also spoke with four carers. We looked at another two people’s care records, training data, further quality assurance records and policies. We continued to seek clarification from the provider to validate evidence found.
Updated
25 August 2021
Here2Care Limited is a domiciliary care agency providing personal care to people living in their own homes. At the time of the inspection the service was supporting 61 people receiving personal care from the service, some of whom were living with dementia.
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.
People’s experience of using this service and what we found
At the last inspection we identified issues with staff deployment and a lack of quality assurance processes that could have identified issues and helped to drive improvement. We also made a recommendation about making information accessible for people.
At this inspection improvements had been made in the management and oversight of staff deployment and people were happy with their care calls. We also found changes had been made which made information more accessible to people.
At this inspection risks to people had not always been recorded and person-centred guidance about managing risks to people and meeting their care needs were not always detailed within people’s care records. The registered manager began to address this following our inspection.
Staff recruitment records contained pre-employment checks however references did not always contain the dates of staff’s previous employment. Therefore the registered manager could not be assured they had staffs full-employment history to ensure safe recruitment practice.
The registered manager had systems in place to monitor the quality of the service however audits had not identified the areas for improvement regarding recruitment and person centred records. Quality monitoring and governance did not include trends analysis to aid learning and improving. The registered manager began to address the governance issues following our inspection.
People told us they were happy with their care. Staff knew how to meet their needs and staff had good knowledge of the people they supported. Therefore, there was no impact from the lack of person-centred information in the records.
People and their relatives told us they felt the service was safe and well managed. People were safeguarded from the risk of abuse by staff who knew the signs and symptoms of abuse to look out for. The registered manager followed their system when dealing with any potential safeguarding concerns.
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.
Medicines were being managed safely by competent staff with oversight from the registered manager. Infection control and prevention procedures were in place and followed by staff.
Staff and the registered manager understood their roles and duties. There was a positive culture within the service encouraged by the registered manager who had made improvements to the service and had further plans to do so.
The registered manager had sought feedback regularly from people and staff about the service. The registered manager worked in partnership with other healthcare professionals and external agencies where required to meet people’s needs.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was requires improvement (published 18 February 2020). There were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection some improvements had been made and the provider was no longer in breach of regulation 18. Issues relating to the breach of regulation 17 from the last inspection had been rectified however the provider was still in breach of regulation 17 due to new issues found at this inspection.
The last rating for this service was requires improvement. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
We carried out an announced comprehensive inspection of this service on 12 December 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve staffing and good governance.
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 and Well-led which contain those requirements. We also targeted information related to the recommendation we made under Responsive at the last inspection.
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 remained the same. 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 Here2Care Limited 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 monitor the service.
We have identified breaches in relation to good governance in the form of record keeping at this inspection.
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 authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.