Caring Hands (Domiciliary Care) Ltd.

Updated 22 September 2022

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 Health and Social Care Act 2008.

Inspection team

The inspection was undertaken by two inspectors and two Expert by Experiences. 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 houses and flats.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager in post.

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.

Inspection activity started on 15 August and ended on 25 August 2022. We visited the location’s office on 15 August 2022.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with nine people who used the service and 11 relatives about their experience of the care provided. We spoke with 10 members of staff including the registered manager, a care co-ordinator and care staff. We also spoke to a social care professional.

We reviewed a range of records. This included 13 people’s care records and 14 people’s medicines records. We looked at five staff files in relation to recruitment. A variety of records relating to the management of the service were reviewed including, but not limited to compliance records, training information, and policies.

Updated 22 September 2022

About the service

Caring Hands (Domiciliary Care) Ltd It is registered to provide personal care to younger and older people with a physical disability; learning disability or autistic spectrum disorder; dementia; sensory impairment, eating disorder and mental health needs.

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 the inspection 108 people were receiving personal care.

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

Quality assurance systems and processes were not always in effective or in place. Medicines systems and processes required further improvements to ensure people received their medicines as prescribed. The implementation of new systems and processes was planned, this needed to be implemented, embedded in practice and sustained over time.

Some people’s care plan reviews were overdue meaning care plans were not always reflective of their current needs. New care plan documentation had been introduced and was being completed for everyone. New care plans we reviewed contained comprehensive information about people’s need and risks. We made a recommendation about end of life care plans.

Improvements had been made to the scheduling of people’s care calls, this had improved staff timekeeping and consistency. Further improvements were planned to improve people’s experience. People told us calls were never missed and that occasionally calls were late but this did not impact them.

Feedback was sought from people, relatives and staff to identify where improvements were needed. Staff felt supported within their roles and felt confident to discuss any concerns they may have with the management team. The service followed government guidance in relation to infection prevention during the COVID-19 pandemic.

People were supported by staff that had been safely recruited, were kind, caring and enjoyed their role. Staff were knowledgeable about people’s healthcare needs and took prompt action when they identified people were unwell. Staff knew people’s dietary requirements and supported people at mealtimes in line with their care plan.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 06 November 2019 and this is the first inspection.

The last rating for the service under the previous provider was good, published on 22 February 2018.

Why we inspected

This was the services first inspection under the new provider.

Enforcement and Recommendations

We have identified a breach of regulation in relation to governance 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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspec