Heron Care Limited

Updated 5 January 2019

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.

This inspection took place on 30 November 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because it is domiciliary care service and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

The inspection team consisted of one adult social care inspector and an expert by experience, who had experience of caring for older adults.

Before our inspection visit we reviewed the information we held on the service. This included notifications we had received from the provider about incidents that affect the health, safety and welfare of people who used the service. We also reviewed the Provider Information Return (PIR) we received prior to our inspection. 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. This provided us with information and numerical data about the operation of the service.

Before the inspection, we had been made aware of safeguarding concerns that had been investigated by the local authority’s safeguarding team and complaints that had been made about the service. Some of these safeguarding concerns had been substantiated and a complaint had been upheld by the local authority. As a result, this inspection did not examine the circumstances of the concerns. However, the outcomes shared indicated potential concerns around the way visits were planned and staff competence in relation to moving and handling people. This inspection examined these areas.

We spoke to 10 people who used the service and two people who had left the service via telephone interviews. We also spoke to seven staff members over the phone and received feedback from three care staff via emails. We spoke with the operations manager, the training manager, a care manager, one administration officer and the registered manager who is also the owner.

We looked at care records of four people, training records for all staff, records of staff visits, three recruitment records of staff members and records relating to the management of the service. We also contacted the safeguarding and contracts monitoring departments at the local authority.

Updated 5 January 2019

This inspection visit took place on 30 November 2018 and was announced.

Heron Care Limited also is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. Not everyone using Heron Care Limited receives a regulated activity. Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

Majority of the people supported by this service live in their own homes. However, the service also supported people who lived in a supported living set up. There were 85 people using the service at the time of our inspection.

At our last inspection in April 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. Any concerns that had been raised had been adequately responded to ensure people’s safety. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take appropriate action when required. They had responded adequately to safeguarding concerns raised by people and professionals. Recruitment checks were carried out to ensure suitable people were employed to work at the service.

Staff skills, knowledge, training and support demonstrated a commitment to providing good standards of care that were embedded into the practices of the staff and the management team. Improvements were required to ensure staff received supervision in line with the organisation’s policy. The registered manager took consideration of people’s views.

Risk assessments had been developed to minimise the potential risk of harm to people who used the service. These had been kept under review and were relevant to the care and support people required.

Care plans were in place detailing how people wished to be supported. People who received support, or where appropriate their relatives, were involved in decisions and consented to their care. However, improvements were required to the process for assessing mental capacity. We found mental capacity assessments had not been completed to demonstrate how decisions had been reached about people’s ability to make decisions about receiving care. We asked the registered manager to address this and made a recommendation about the assessment of people’s mental capacity. People’s independence and choice was promoted.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required. People told us their medicines were safely managed.

We found people had been assisted to have access to healthcare professionals and their healthcare needs were met and reviewed regularly. People’s independence was promoted, and staff ensured people remained active members of their local community.

People who used the service and their relatives knew how to raise a concern or to make a complaint. The complaints procedure was available, and people said they were encouraged to raise concerns and complaints had been addressed. Staff had received compliments from people's relatives.

The majority of the feedback we received from staff and people who used the service was positive. However, we also received mixed feedback from two staff members and two people about the way care visits were arranged, management and staff competences. We shared the views with the registered manager.

The registered manager used a variety of methods to assess and monitor the quality of service provided to people. These included regular internal audits of the service, surveys and staff meetings to seek their views about the quality of care they provided and their job.